Wellness & Fitness

Morning sickness: When vomiting during pregnancy isn't normal


Hyperemesis gravidarum is a condition that occurs during early pregnancy and causes excessive nausea and vomiting. PHOTO | SHUTTERSTOCK

Simple nausea and vomiting during pregnancy are common, affecting about four in five pregnant women. However, hyperemesis gravidarum which is the more severe form of vomiting during pregnancy, affects less than one in 20 women.

This is a condition that occurs during early pregnancy and causes excessive nausea and vomiting, with no other cause identified. It often leads to one being hospitalised for in-patient treatment.

There is a higher chance that it might recur in future pregnancies once one has been affected. Here is what you need to know about this condition and how to manage it at home.

Symptoms of hyperemesis gravidarum usually start during the first 2 to 3 months of pregnancy (around week 6 to week 9). Most people feel better by the time they are midway into their pregnancy. However, some people feel sick until late in pregnancy or even into labour and delivery.

Observable and obvious symptoms include vomiting every day - often many times a day, inability to retain anything that is eaten (one throws up immediately after eating or drinking), weight loss and dehydration because of too much vomiting. Some of the symptoms of dehydration include urinating less often than usual, having dark yellow urine and feeling dizzy when standing up.

You should head to the hospital if the above symptoms present. The diagnosis of hyperemesis gravidarum is usually based upon weight loss of up to five percent of your pre-pregnancy weight, a history of nausea and vomiting that are persistent and not responding to oral medication and lifestyle interventions and dehydration, and electrolyte imbalances.

A few lifestyle adjustments can be made to try and improve your symptoms or prevent them.

Here are some things that you can try on your own and see if they can make a difference; eat small but frequent meals, eat as soon as you feel hungry, or even before you feel hungry, and avoid spicy, odorous, high-fat, acidic, and very sweet foods. Substitute protein-dominant, salty, low-fat, bland, and/or dry foods such as crackers, toasted bread, nuts, and low-fat yoghurt.

Snack often and eat small meals to avoid a full or empty stomach, drink cold, clear beverages, such as sports drinks and ginger ale. Avoid coffee, drink between meals, rather than with a meal to minimise the full stomach effect.

Try ginger-flavoured foods, brush your teeth right after you eat, avoid lying down or going to bed right after you eat, take your prenatal supplements at bedtime with a snack, not in the morning, avoid things in your environment that upset your stomach, such as stuffy rooms, strong smells, hot places, irritating images/pictures or loud noises, have someone make your meals for you.

Management of hyperemesis gravidarum depends on how severe your symptoms are. If you are unable to tolerate anything, are dehydrated or have lost a lot of weight, you will probably need admission and get treated in the hospital with fluids that go into your vein through a tube called an "IV" (intravenous).

This way, the doctor will use IV medicines to help stop your nausea and vomiting, being kept nil by mouth (that is not being allowed to eat anything to rest your tummy), if this treatment doesn't work, your doctor can feed you through a tube that goes in your nose and down into your stomach or through a vein.

Babies born to people with hyperemesis gravidarum for the entire pregnancy are a little more likely to be smaller than average. But otherwise, the condition doesn't seem to cause problems for your baby.

Dr Okemo is a consultant obstetrician gynaecologist at Aga Khan University Hospital, Nairobi.