June 17, 2007
Excerpts from Beyond Morning Sickness
Battling Hyperemesis Gravidarum
Effects of HG
A hyperemetic mother can vomit between four and twenty (or more) times a day for months. If, starting at six weeks, a particular woman vomits an average of fifteen times a day she will have endured several hundred emetic episodes by twenty weeks. Imagine the discomfort of vomiting that much in such a short span of time! The vomiting can be so frequent that the stomach acid erodes tooth enamel. The emesis itself is often bile-filled and blood tinged (the blood usually comes from small tears in the esophagus, stomach or duodenum), and the cycle is self-perpetuating and relentless. In addition to the excessive vomiting, a severely hyperemetic mother suffers from weight loss, dehydration and metabolic disturbances.
The nausea and vomiting of HG make it nearly impossible for the mother to eat or drink much, if anything. Obviously, if you don't eat you lose weight. Again, losing greater than 5% of your total body weight is one clinical indication supporting a diagnosis of severe HG. Dehydration Fluid, which makes up around two-thirds of a person's body weight, is vital, because every single process in our bodies occurs in a fluid medium. Surprisingly, dehydration can cause nausea and vomiting, and that's the last thing a hyperemetic wants more of. Some symptoms of dehydration are lowered blood pressure, headache, blurred vision and fever.
Electrolytes are chemical compounds that break down into such elements as potassium and salt in the body fluid, and they play a vital role in stabilizing body systems. Electrolyte imbalance may manifest as a tingling sensation in the hands and feet, general weakness, decreased reflexes or reaction times and other symptoms. Carbohydrate Depletion and Ketonuria Carbohydrates include sugars, starches, and fibers. They are the body?s main source of energy, and if carbohydrate levels are inadequate, a person?s body begins to break down fat for energy and may take energy from muscle and even organs. This can disrupt the nervous system.
The central nervous system refers to the brain and spinal cord and conscious motor activities like walking and talking. The peripheral nervous system involves automated functioning such as the heartbeat and digestion. Your body needs energy to function. Carbohydrate depletion causes weariness with a capital ?W?, and it can make a three-step trip to the toilet feel like world travel.
Additionally, when the body must break down fat for energy, this creates substances called ketones, which can make the blood too acidic. If your urine is flooded with ketones it is a sign that you are in a period of starvation.
If you are living with the suffering of HG, don?t let your physicians tell you that you're not sick but only having a baby. You are sick. HG is not a normal pregnancy experience. However, be encouraged; there is good news!
HG and Pregnancy Outcomes
With so much nausea and vomiting, adequate nutrition is obviously an issue. A good diet and vitamins during pregnancy have been so fanatically drilled into society that many of us incorrectly assume that a woman who eats negligible amounts and hyper-vomits for months is going to have a malformed, severely retarded baby if the little one even survives. Fortunately, nothing could be further from the truth. The body has a miraculous compensatory ability, and a severely hyperemetic woman with sufficient medical care has as much chance at a successful pregnancy outcome as anyone. In fact, some studies have shown that hyperemetic mothers have a reduced risk of miscarriage and no increased rate of birth defects.[13-14] However, alternative nutrition is often considered in cases involving a total body weight loss of 10% or more, in order to prevent low birth weight and prematurity.
 Gardner DK Hyperemesis gravidarum
Pharmacist (Aug 1997)p47-66
 Hallak, et al. Hyperemesis gravidarum: Effects on fetal outcomes
J Reprod Med (Nov 1996)v41n11p871-4
 Eliakim R, et al.
 van de Ven CJ Nasogastric enteral feeding in hyperemesis gravidarum Lancet (Feb 1997)v349n9050p445(2)