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The Hunger Project Bolen Report
Ohm Society
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Hyperemesis Gravidarum Print E-mail
by Ron Kennedy, M.D., Santa Rosa, CA

Dr. Kennedy Morning sickness is a problem in 70% of pregnancies, the more severe and dangerous condition known as hyperemesis gravidarum (literally pregnant over-vomiting) occurs in only three pregnancies of every 1000 (0.3%). Most cases happen in the first 8-12 weeks of pregnancy.

Signs and symptoms in the mother Signs and symptoms in the fetus
nutritional deficiencies and weight loss prematurity
persistent vomiting with electrolyte imbalance, dehydration, and esophageal tears low birth weight
neurological symptoms increased incidence of nervous system malformations
acid base imbalance increased incidence of skin malformations
kidney and liver damage increased incidence of testicular cancer in male children later in life

There are other causes of persistent vomiting which should be considered and ruled out before making the diagnosis of HG. Infection and/or inflammation of the kidneys, pancreas, liver, gall bladder, appendix, stomach and small intestine as well as hyperthyroidism should all be considered. When the onset is late in pregnancy, toxemia of pregnancy should also be considered.

While the cause of HG is not understood, hormonal imbalances are suspected. The incidence is higher in unwanted pregnancies which leads to the suspicion that psychological stress plays a role. This idea is supported by the fact that improvement with hospitalization is common as is relapse with discharge back to the home environment.

Treatment consists of anti-nausea drugs, intravenous fluids to restore electrolyte balance as well as fulfill the need for calories, usually with glucose or, in the case of intractable vomiting, intravenous replacement of all major nutrients. Replacement of vitamins is also very useful and a preparation known as Myer's cocktail has proven quite effective.



The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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