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Hyperemesis Gravidarum

What is hyperemesis gravidarum?
Hyperemesis gravidarum is severe nausea and vomiting during pregnancy. It causes the loss of 5 percent or more of your body weight. It can also lead to a decrease in body fluid and nutrients. The nausea and vomiting may go away and come back again. It may take a while, but most of the time the nausea and vomiting are over by 20 weeks of pregnancy.

What causes hyperemesis gravidarum?
The cause of hyperemesis gravidarum is not known. Women who are less than 20 years old, have increased body weight, are carrying twins, had hyperemesis gravidarum in a previous pregnancy or are pregnant for the first time are more likely to have hyperemesis gravidarum.

If I cannot eat enough, will my baby grow?
Your baby will most likely be fine. Hyperemesis gravidarum usually has no affect on the baby. There is a chance that your baby could be small. The goal of treatment is to keep you well nourished. Keeping you well nourished will allow your baby to keep growing.

What is the treatment for hyperemesis gravidarum?
It is important to be weighed frequently to be sure that you do not continue to lose weight and to see if you are gaining weight.

Your blood and urine may be tested to be sure that you are getting enough calories and nutrients for you and your baby.
When vomiting becomes such a problem that you are losing too much weight and body fluids, you will need to be cared for in the hospital. You will be given nothing by mouth until the vomiting has stopped. An intravenous line (IV) will be started so that you can be given fluids directly into your blood stream.

Medicines such as Phenergan®, Compazine®, Reglan®, or Zofran® may be given to stop the nausea and vomiting. Medicines given to decrease acid in your stomach such as Axid®, Tagamet®, Zantac®, Propulsid®
may also be given.

Once you have stopped vomiting, you will be able to slowly start eating again. Most women feel better in time. Small frequent meals, avoiding greasy and highly seasoned foods, and taking fluids between meals instead of with meals can help.

Rarely, some women are not able to eat enough by mouth, even with medications, and need to be fed in other ways. Total parenteral nutrition (TPN) is a special IV fluid with sugar, protein, vitamins and minerals that can be given to be sure that you are getting enough food and fluids. It is usually given through a special IV line that is placed below your collarbone or through a special long IV line that is placed in the skin on the front side of your elbow (PICC line). Tube feeding is another way to provide nutrition. A tube can be put through your nose, past your stomach and into your intestines. A liquid diet is given through the tube. TPN and tube feedings can be done at home, after you leave the hospital.

Questions?
If you have any questions about hyperemesis gravidarum or your care at North Carolina Women’s Hospital, please feel free to ask your doctor or nurse for more information.