Understanding hyperemesis gravidarum and why it’s not just morning sickness

Understanding hyperemesis gravidarum and why it’s not just morning sickness

Ayu is an expectant mother with a young toddler and while this time has been incredibly exciting as her family grows, she has been impacted by a truly crippling medical condition known as hyperemesis gravidarum.

Obstetrician Dr Leanne Chapman explains hyperemesis gravidarum is severe and persistent nausea and or vomiting in pregnancy and is associated with the expectant mother experiencing weight loss, dehydration and electrolyte deficiencies.

“Hyperemesis gravidarum is much more severe than morning sickness, it commonly starts between week four to ten of pregnancy and settles down around week 20 however some women can struggle with it for the duration of their pregnancy,” Leanne said.

“Around one per cent of expectant mothers will be impacted by hyperemesis gravidarum, while 70 per cent will experience standard morning sickness. Risk factors include mothers carrying twins or triplets, carrying a female baby and some women can be genetically predisposed to it, however sometimes it can be out of the blue.”

Ayu experienced hyperemesis gravidarum in her first and now second pregnancies at the six-week and four-week mark respectively, however says during her second pregnancy the illness has been more severe.

“It feels super awful, not painful although it can be for the throat, chest and stomach after five to six hours of straight vomiting, dry heaving and gagging. I have thrown up blood a few times and there is this constant awful taste in my mouth,” Ayu said.

“I am so thirsty and hungry all the time, but any liquid or food will send me straight to the bathroom. I feel nauseas 24/7 and it’s hard to eat or even move from bed some days.”

Leanne says the impact this can have on women is severe as mothers can suffer from low blood pressure and fainting spells as they can’t keep fluid and food down and if untreated can lead to other more serious complications such as kidney damage.

“Some women can become constipated from their medication which is exacerbated by not being able to keep down water, we may see erosion of the teeth and even oesophagus from the constant vomiting,” she said.

“Hyperemesis gravidarum can also take an emotional and financial toll on women and they are more likely to experience depression and prenatal anxiety. They can be so unwell they can’t care for their other children and in many cases cannot continue to work.”

Ayu said the impact it had on her life was extreme as during her first pregnancy she had to stop working and during her second she felt she wasn't able to spend precious time with her daughter.

“I feel like the worst mum in the world some days, I have massive guilt with my husband as I haven’t been able to cook or clean the house some days as the smell of any kinds of food or cleaning products would send me straight to the toilet or feeling so nauseas,” Ayu said.

Leanne explains there are treatment options available for mothers and the team take a multidisciplinary approach to their care.

“First of all, we need to ensure it is hyperemesis gravidarum and not any other illness, so we perform blood tests including checking electrolytes. We can give medications to reduce the vomiting and nausea but unfortunately we can’t get rid of symptoms completely,” Leanne said.

“Women can find themselves on lots of medication, needing regular IV fluids and requiring more frequent antenatal visits. They may also need to see a dietician to manage their weight and ensure they are getting adequate nutrition plus a social worker or psychologist to check on their mental health and wellbeing.”

Ayu says Dr Chapman has been heaven sent, as she received fluids whenever needed and has trialled several medications before finding the right fit, she also has regular check-ups to ensure she and her baby are well.

“Getting regular IV FLUIDS and a few medications through the drip have been a game changer but it only lasts for a short time. Better than no treatment though,” Ayu said.

For mothers who feel their morning sickness is extreme and fear they may have hyperemesis gravidarum Leanne says speak to your obstetric care provider.

“Your obstetrician, GP or midwife should be able to help you through this, but you can always seek a second opinion. Mater has an excellent obstetric medical team who are well placed to manage these conditions with your care team,” Leanne said.

For Ayu her advice to other mothers would be trust your instincts especially if you are suffering all the time and it has stopped you from completing simple daily tasks, seek help.

“Join a Hyperemesis support group on Facebook, it is such a nice support network to have other women who understands what it’s really like to be pregnant with this rare condition. You are not alone. It is ok to feel like you hate being pregnant but also grateful at the same time,” Ayu said.

“It really is worth it at the end though, accept and ask for help from friends and family (especially if you have other children in care) and hang in there.”

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For urgent assessment at any stage of your pregnancy, please present to your nearest emergency centre or Mater Mothers’ 24/7 Pregnancy Assessment Centre in South Brisbane.

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