Hyperemesis gravidarum is nausea and vomiting that occurs excessively during pregnancy. Nausea and vomiting ( morning sickness ) in the first trimester of pregnancy is actually normal . However , in hyperemesis gravidarum , nausea and vomiting can occur throughout the day and run the risk of causing dehydration.
Not only dehydration, hyperemesis gravidarum can cause pregnant women to experience electrolyte disturbances and weight loss. This condition needs to be treated immediately to prevent health problems for pregnant women and their fetuses.
Causes of Hyperemesis Gravidarum
The cause of hyperemesis gravidarum is not known for certain, but this condition is often associated with high levels of the hormone human chorionic gonadotropin (HCG) in the blood. This hormone is produced by the placenta (placenta) since the first trimester of pregnancy and its levels continue to increase throughout pregnancy.
There are several conditions that make pregnant women more at risk of experiencing hyperemesis gravidarum, namely:
- First time pregnant
- Pregnant with twins
- Suffer from obesity
- Having a family who has experienced hyperemesis gravidarum
- Experiencing hyperemesis gravidarum in a previous pregnancy
- Experiencing a molar pregnancy
Symptoms of Hyperemesis Gravidarum
The main symptoms of hyperemesis gravidarum are nausea and vomiting during pregnancy , which can occur up to 3–4 times a day. This condition can lead to loss of appetite and weight loss. Excessive vomiting can also cause pregnant women to experience dizziness, weakness and dehydration .
Apart from excessive nausea and vomiting, sufferers of hyperemesis gravidarum can also experience additional symptoms in the form of:
- Headache
- Constipation
- Very sensitive to odors
- Urinary incontinence
- Excessive saliva production
- Heart beat
Symptoms of hyperemesis gravidarum usually appear at 4–6 weeks of gestation and begin to subside at 14–20 weeks of gestation.
When to see a doctor
Pregnant women are encouraged to undergo regular prenatal checks to the obstetrician from the beginning of pregnancy. That way, the condition of the mother and fetus can always be monitored. The recommended pregnancy check-up schedule is:
- Gestational age 4–28 weeks: 1 time every 1 month
- Gestational age 28 – 36 weeks: 1 time every 2 weeks
- 36-40 weeks of gestation: 1 time every 1 week
In addition to carrying out routine checkups, pregnant women need to see a doctor immediately if nausea and vomiting get worse or are accompanied by:
- Dizzy
- Not eating or drinking for 12 hours
- Stomach ache
- Symptoms of dehydration, such as weakness, infrequent urination, dry skin, and palpitations
- Vomiting blood
- Weight loss drastically
Diagnosis of Hyperemesis Gravidarum
In diagnosing hyperemesis gravidarum, the doctor will ask about symptoms and examine the medical history of the pregnant woman and her family. A physical examination is also carried out to see the effects of hyperemesis gravidarum, such as low blood pressure and fast heart rate.
From a physical examination, the doctor can determine whether the vomiting experienced by pregnant women is still normal or excessive (hyperemesis gravidarum). To see in more detail the consequences of hyperemesis gravidarum, the doctor will carry out further examinations.
Follow-up examinations can be carried out with blood and urine tests. The goal is to check for signs of electrolyte disturbances and dehydration. Pregnancy ultrasound is also performed to monitor the condition of the fetus and detect abnormalities in the womb.
In addition, to ensure that the symptoms of nausea and vomiting experienced by pregnant women are not caused by an illness, such as liver disease , the doctor will carry out further tests, for example liver function tests .
Treatment of Hyperemesis Gravidarum
Unlike morning sickness , which can be treated at home, hyperemesis gravidarum sufferers need to be treated in a hospital. The treatment given is determined based on the severity of symptoms and the overall health condition of the pregnant woman.
Treatment aims to stop nausea and vomiting, replace fluids and electrolytes lost due to excessive vomiting, meet nutritional needs , and restore appetite.
Some of the drugs that can be given by doctors are:
- Anti-nausea medications, such as promethazine
- Vitamin B1 or thiamine
- Pyridoxine or vitamin B6
- Vitamin and nutritional supplements.
If hyperemesis gravidarum causes pregnant women to be unable to swallow liquids or food at all, the doctor will provide drugs and nutrients through an IV . Apart from infusion, pregnant women can also receive food intake through a feeding tube.
Hyperemesis Gravidarum complications
Hyperemesis gravidarum can endanger the condition of pregnant women and the fetus. Excessive nausea and vomiting will cause the body to lose a lot of fluids so that it risks triggering dehydration and electrolyte disturbances. If left unchecked, these two conditions can cause deep vein thrombosis in pregnant women.
Some other complications that can occur are:
- Malnutrition
- Impaired liver and kidney function
- Mallory-Weiss syndrome , which is a tear in the inner wall of the esophagus (oesophagus)
- Vomiting blood , which is caused by bleeding from a tear in the esophagus
- Anxiety and depression
If not treated immediately, hyperemesis gravidarum can cause the organs of the pregnant woman's body to fail and the baby to be born prematurely .
Prevention of Hyperemesis Gravidarum
Not yet known how to prevent hyperemesis gravidarum. Even so, there are several efforts that can be made to relieve morning sickness so that it does not develop into hyperemesis gravidarum, namely:
- Adequate rest time to relieve stress and relieve fatigue
- Eat foods high in protein , low in fat, and smooth in texture so they are easy to swallow and digest
- Eat small but frequent meals, and avoid oily, spicy or strong-smelling foods, which can trigger nausea
- Drink plenty of water to prevent dehydration
- Consuming drinks containing ginger to relieve nausea and warm the body
- Taking pregnancy supplements to meet the needs of vitamins and iron during pregnancy
- Using aromatherapy to reduce morning sickness
Maintaining a healthy pregnancy during the first trimester is also important to do to prevent hyperemesis gravidarum, one of which is by having routine pregnancy checks.
Pregnancy checks are generally carried out from 4 weeks of gestation, to monitor fetal development and detect early any abnormalities that may occur in the fetus.