Dr Suman Bijlani, Gynaecologist, Sonologist, Infertility Specialist, Obstetrician and Laparoscopic Surgeon, Mumbai.

Excessive vomiting in pregnancy

What exactly is Hyperemesis Gravidarum?

Hyperemesis gravidarum is a medical term for excessive vomiting during pregnancy, especially in the first trimester. It is an exaggerated form of morning sickness, to the extent that, you as a mother-to-be may experience significant weight loss and vomiting. You may be unable to eat, or even tolerate the smell or sight of food. You may throw up every time you eat anything at all. Prolonged periods of going without food or water cause acidity which worsens nausea and vomiting. This causes a vicious cycle and you may go for days without much food.

The condition is particularly distressing because of the severe retching and inability to eat, even though you may be very hungry!


How many women does it affect?

Most women (70-80%) experience varying degrees of nausea and vomiting in early pregnancy. Hyperemesis gravidarum affects about 1% pregnant women.

It is commoner if you have a multiple pregnancy (twins or triplets) and in a condition called vesicular mole (a type of abnormal pregnancy).

The condition usually begins in the second month of pregnancy (5th to 6th week) and usually subsides by the end of the third month although it may continue till even the fifth month in some cases.

The condition also tends to recur in future pregnancies, although it is impossible to predict for whom it will.


Is there any way apart from hospitalisation to treat/ avoid it?

Unfortunately, there is no known way to prevent the condition. However, one can definitely manage it well.

If you are dehydrated, you may need to be hospitalised and given IV fluids, anti-vomiting medication and antacids. Your obstetrician may also perform tests for liver or gastrointestinal condition.

In rare cases, if things do not get better, you may need to be fed through a tube passed into your stomach.


What should a woman who suffers from it do and not do during pregnancy?

Do –

  • Seek medical help early
  • Confirm whether you have twins or vesicular mole (sonography)
  • Eat small but frequent meals
  • Eat dry snacks such as crackers or biscuits first thing in the morning
  • Keep yourself distracted. Watch movies, read and carry on with your routine activities as far as possible.
  • Eat raw, bland and minimally seasoned foods
  • Drink plenty of fluids (in various forms)
  • Suck on a ginger drop/ peppermint or drink ginger ale
  • Go out for fresh air as much as possible
  • Seek emotional support from spouse, family, friends

Don’t –

  • Lose heart. It is only a matter of time and your condition can be easily tided over with some medical help.
  • Eat spicy, junk or fried foods
  • Cook, if you cannot tolerate strong smells or fumes
  • Self-medicate. Contact your obstetrician for medicines which are safe for your baby
  • Go without food or liquids for prolonged periods (it increases acidity)
  • Feel guilty. It is not your fault.
  • Worry. Babies’ requirements are low in the first trimester. You may actually lose weight, but that won’t harm the baby’s growth.

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