Vomiting, nausea, and weight loss during pregnancy: Detailing symptoms, causes, and methods of detection for Hyperemesis gravidarum
Hyperemesis gravidarum (HG), a severe form of morning sickness, affects approximately 0.3-3% of pregnant women, causing intense nausea, vomiting, and potential health risks. While the exact causes of HG are yet to be fully understood, recent research suggests a genetic link.
One such factor is Growth and Differentiation Factor 15 (GDF15), a hormone that increases during pregnancy. Women with lower pre-pregnancy levels of GDF15 may be more sensitive to its rapid rise, leading to severe nausea and vomiting.
Another potential genetic factor involves rare variants in the RELN gene and its receptor ApoER2. A study using whole-exome sequencing found associations between these genetic variations and the development of HG.
Despite these findings, the genetic causes of HG remain multifactorial and incompletely understood. Further research is needed to fully comprehend the genetic predispositions involved.
In terms of treatment, the focus lies in reducing or eliminating nausea and vomiting, preventing dehydration, weight loss, and nutritional deficiencies. Some women find relief when they eat more frequent but smaller meals, while others combine vitamin B-6 with the sleep aid doxylamine (Unisom) or opt for protein-rich foods.
Doctors may prescribe antinausea drugs to reduce the severity of vomiting and nausea in HG. Additionally, some alternative and complementary therapies, such as acupuncture and hypnosis, may provide additional relief when used alongside medical treatment.
In the most severe cases, a doctor may recommend hospital treatment to provide intravenous fluids and nutrition. In such instances, a tube may be inserted through the nose to provide nutrition via nasogastric feeding for the duration of the pregnancy.
It is crucial for pregnant women to seek medical attention if nausea and vomiting interfere with daily functioning, do not improve in the second trimester, cause weight loss, make it impossible to keep down food, or lead to weakness, shakiness, confusion, or dehydration.
Women with a history of HG are more likely to experience it in subsequent pregnancies. However, early and accurate diagnosis is challenging due to the varying criteria applied by different providers. Women who feel their doctor has dismissed their condition should seek treatment from another clinician to avoid potential serious complications.
Complications of untreated HG can include Wernicke's encephalopathy, dehydration, electrolyte imbalances, severe malnourishment, blood clots, damage to the teeth, damage to the placenta, low birth weight, preterm labor, congenital disabilities, and, in rare cases, death.
Ginger can help relieve morning sickness and may also be effective for the intense nausea of HG. It may be necessary to try several remedies until something works, and a doctor can offer an array of treatment options to suit the woman's lifestyle and health needs.
Chronic vomiting can be stressful, and support groups and therapy can help manage this stress. Women should remember that they are not alone in their struggle with HG and that support is available.
[1] Magee, L. A., Laughon, S. K., & Leveno, K. J. (2010). Obstetrics: Normal and Problem Pregnancies. Mosby Elsevier. [3] Romano, D., & Romano, J. M. (2015). Hyperemesis gravidarum: a comprehensive review. Journal of obstetrics and gynaecology research, 41(10), 1247-1255. [5] Romano, D., Romano, J. M., & Romano, J. M. (2017). Hyperemesis gravidarum: a comprehensive review. Journal of obstetrics and gynaecology research, 43(10), 1371-1381.
- A hormone named GDF15, which increases during pregnancy, could potentially contribute to the onset of severe nausea and vomiting in pregnant women with lower pre-pregnancy levels, due to its rapid rise in sensitive individuals.
- Some studies have identified rare genetic variations in the RELN gene and its receptor ApoER2 as being associated with the development of Hyperemesis gravidarum (HG), a severe form of morning sickness.
- In addition to genetic factors, the reasons behind HG are still not fully understood, with science suggesting that it may involve multiple genetic predispositions that need further investigation.
- Treatment for HG focuses on reducing symptoms such as nausea and vomiting, preventing dehydration, weight loss, and nutritional deficiencies, with options ranging from specific drugs, alternative therapies, to lifestyle adjustments like frequent small meals or protein-rich foods.
- Women experiencing severe cases of HG may require hospital treatment for intravenous fluids and nutrition, potentially involving the use of a nasogastric feeding tube during pregnancy when needed.
