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Hyperemesis: One Of Uncommon Symptoms of Pregnancy

Jenny Decker RN's picture

The first few days of morning sickness, one of the most common symptoms of pregnancy, it was not so bad. Sure, maybe running to the bathroom once or twice, having to eat to keep from vomiting, and being fatigued were bothersome. But then the vomiting becomes more frequent, sometimes every half hour or every fifteen minutes. Salivation increases to the point of having to use a cup to spit in. Headaches set in and fatigue is so bad, it is a journey from the bed to the bathroom. This is called hyperemesis. To understand hyperemesis, it is important to understand the difference from morning sickness. Morning sickness is a common group pregnancy symptoms and it occurs in fifty to ninety percent of pregnancies.

Morning sickness tends to last from 12-20 weeks. It can affect some aspects of life such as some loss of work, but generally this may be up to 3 weeks. With the common sign of pregnancy that is morning sickness, household responsibilities can be performed at times of the day when symptoms are less intense. Fatigue generally results in some decrease of workload and resting is often recommended. Nausea and vomiting of pregnancy can also affect relationships temporarily until it is resolved. Finances are minimally affected. Psychological stress is mild, sometimes moderate, but manageable.

What happens when the normal signs of pregnancy get worse? On the severe end of nausea and vomiting of pregnancy is the condition called hyperemesis gravidarum. Generally, the pregnant woman will start with mild to moderate symptoms thinking it is morning sickness. But these can increase to a point where it becomes necessary for medical intervention.

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There is no official set criteria as to where morning sickness stops and hyperemesis begins. Little research on the impact of morning sickness has been done to differentiate morning sickness from hyperemesis. Hyperemesis often requires the pregnant woman to be hospitalized with restoration of fluids and electrolytes to correct dehydration. This is done intravenously. Other methods of treatment include antiemetics to control the nausea and vomiting. Some of these medications include zofran, atarax, and phenergan. When normal symptoms of pregnancy turn to more severe symptoms, impact on the woman and her family can be severe.

Hyperemesis often results in not being able to work and many women lose their jobs or they are forced to resign. Performing household chores must be done by someone else. The woman with hyperemesis oftentimes cannot even shower herself. Fatigue becomes severe and last for months. Bed rest is often a necessity. Relationships become strained and some may end in divorce or separation. When the woman is so sick and relationships become so strained, isolation and depression become real concerns. These are not normal symptoms of pregnancy.

Financial loss is severe. From loss of work high costs of medical care, and additional services needed, such as expensive hospital stays and medications, financial problems are often devastating. All this can result in moderate to severe psychological stress. These women are at high risk for postpartum depression and post traumatic stress disorder. Recovery can take from months to years. The impact of these severe signs of pregnancy takes its toll.

Hopefully normal pregnancy symptoms are mild and resolve on their own. However, those who begin to swing to the severe side of the continuum will need medical care, but mostly they will require support and understanding from all those who are around them, from their boss to right at home with family.

By Jenny Decker, RN
National Organization for Rare Disorders
Hyperemesis Education and Research Foundation