This condition is not just vomiting in pregnancy as many of us think; it is severe, debilitating nausea and vomiting. It is generally related with weight loss and electrolyte disturbance. It is much worse than just morning sickness. But the big question is who is getting hyperemesis gravidarum and why and what to do to prevent it;

Women suffering of hyperemesis gravidarum are mostly treated in hospital with intravenous fluids and anti- sickness medication until they are able to start eating again.

A lot of women experience some sort of morning sickness in pregnancy and it subsides at 12 weeks but hyperemesis gravidarum can continue over 12 weeks gestation.

The real cause is still unknown; a theory is the higher hormone levels in pregnancy and so women with twins suffer more often with hyperemesis gravidarum.

Unfortunately there is no prevention at all however they are ways to manage it. Not always immediately successful but worth to try before being admitted to the hospital.

Acupuncture, homeopathic treatments, hypnotherapy and sophrology are possibilities to improve the symptoms. Reducing stress levels and bed rest can be helpful; so can ginger in all forms (teas, cookies, lozenges etc.)

Medication such as metoclopramide in combination with cyclizine is very effective however it can make women very tired and therefore I prescribe these only if there is enough support to manage daily life and possibilities to rest.

In addition to sickness and vomiting there could be symptoms of dehydration such as headaches, confusion and extreme tiredness. This again can lead to anxiety and depression which is very stressful and leads to a vicious circle.

Women with hyperemesis gravidarum need medical as well as social support to help this phase of the pregnancy to be manageable and to be able to finally enjoy the pregnancy again.

Etienne Horner Obstetrician & Gynaecologist