Extreme morning sickness: what is hyperemesis gravidarum?

-Dr.Dianne McCallister, Chief Medical Officer at Centura's Porter Adventist Hospital

The headlines from London this week are centered around the pregnancy of the Duchess of Cambridge - Kate Middleton..  

The news broke because Kate is hospitalized with severe nausea and vomiting from pregnancy.  
Morning sickness is very common in pregnancy - particularly in the first trimester -or first 12 weeks of pregnancy.  

Most women find ways to cope with this at home - but up to two percent have such severe nausea and vomiting that they require IV fluids and medications to maintain an appropriate amount of fluid in their body.  

Many cases of hyperemesis gravidarum taper off by 21 weeks. However others can experience symptoms throughout their entire pregnancy.

Gastric ulcers, esophageal bleeding, and overall malnutrition can result from the vomiting, according to the HER Foundation of Hyperemesis Education and Research.

What causes morning sickness?
Morning sickness is believed to be related to the hormonal changes in pregnancy - levels of estrogen and progesterone become very high.  

However - there are other problems that need to be considered - such as thyroid and liver problems - just to make sure they are not contributing.

There are a few reasons that some women may be more likely to get sick - this includes:

  • Twins, triplets or other multiples
  • A history of nausea or vomiting from motion sickness, migraines, smells or tastes when using birth control pills
  • A history of morning sickness in previous pregnancies

In general, morning sickness is not dangerous in itself - but there can be complications that are dangerous

  1. Dehydration - which can produce dizziness, fainting and kidney disorders
  2. A tear in the esophagus (the tube from the mouth to the stomach
  3. Bleeding in the stomach
  4. Failure to gain the appropriate amount of weight due to the lack of nutrition

Coping With Morning Sickness

It is important to discuss how to handle your nausea with your physician, however, many women find that the following can help:

  • sipping on ginger ale or lemon lime soda
  • eating a little bit frequently - soda crackers are often a favorite
  • avoid smells or foods that trigger nausea
  • walking outdoors

Some women do not respond to these home therapies and may require a B6 vitamin supplement or antinausea medication.


Dr. McCallister is on 7NEWS at 11 a.m. every Wednesday. If you have a topic or question you would like her to discuss, email 11am@thedenverchannel.com .

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