It can have severe consequences, Dr Penny Sheehan, Head of Maternity Unit at the Royal Women's Hospital explains.
How does Hyperemesis gravidarum differ to morning sickness?
Most women have some nausea in pregnancy. The bottom line is if you're well enough to stay at home, then it's just the nausea and vomiting of pregnancy. But if you present to hospital dehydrated, then we call it Hyperemesis.
How is it treated?
Treatment starts with general lifestyle things to manage the condition. For some women, smell is a huge trigger, particularly cooking smells, so for that we tell them not to cook. If you find that it is particularly bad at night, then we advise you to try not eating at night.
Keeping up your fluids is most important. If you're having trouble eating any food, then just come down to fluids. Keeping your stomach full with dry salted crackers [can help].
Then we move onto other things, ginger in the form of tablets or tea, for example. There's an acupressure site near the wrist that has been shown to be helpful.
[If medication is required], we start with metoclopramide. That's the mainstay for most people; you can take it up to three times a day. Then there are a range of other things, including Doxylamine, which has a different method of action. It's a night-time sedative. Different things work for different women.
Are certain women predisposed to the condition?
Yes, it's related to high beta hCG – the pregnancy hormone. That can happen with twins, [but also where] there are some unusual conditions of the placenta.
How serious is it?
It can be very serious. In the old days, it was a cause of death. Charlotte Bronte actually died of it. But it is very, very rare that it could be a cause of death these days. [However] there is a link with depression and anxiety because it's so debilitating.
One of the comforting things is that patients that tend to get very sick are less likely to miscarry.
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