Hyperemesis gravidarum

Nausea and vomits are frequent during the pregnancy. The main causes are a rapid increase of oestrogen levels and the beta subunit of the human chorionic gonadotropin (beta-hCG). Generally speaking, they appear during the 5th gestational week until they reach its peak at the 9th week and disappear between the 16th and 18th week.

Hyperemesis factors to take into account are:

• Hyperemesis gravidarum previous symptoms related to previous pregnancies.
• Nulliparity (no previous children).
• Obesity.
• Multiple birth.
• Molar pregnancy (a complication of some pregnancies produced by a b-hCG increase).

Hypermesis gravidarum is an unfrequent disorder characterised by persistent and severe nausea and vomits (everyday and various times a day) that prevent from a correct alimentation of the gestant. As a consequence, an important weight loss is produced (more than 5% of the initial weight count), dehydration and metabolic alterations. Women that suffer from hypermesis gravidarum do not intake enough food to proportionate enough energy to the organism. To actually do that, fats in the body are used to generate that energy and, as a result, an accumulation of metabolic waste (ketones) also called ketosis. This can cause fatigue, malodorous breath and dizziness.

Dehydration produced by hyperemesis gravidarum is directly associated to an increse in cardiac frequency (tachycardia) and, in rare occasions, abnormal cardiac rhythms (arrytmia).

When suspecting it, it is important to do a blood test and urine sediment to determine the existance of dehydration and check on electrolytic alterations. Also, an obstetric ultrasound must be done to assess the foetus state and consider if it is a multiple birth or molar pregnancy.

The treatment for hyperemesis gravidarum depends on the severity of the symptoms. Initially, it can be treated with pharmacs to diminish nausea and vomits. In some cases, it may be necessary to be admitted to the hospital to administer serums and intravenous electrolytes.