Morning sickness during the first trimester is not uncommon for most expectant women. In fact, the American Pregnancy Association estimates that about 70 to 80% of all women experience some type of morning sickness during pregnancy.

However, there's a small percentage of women that experience extreme vomiting and other complications during pregnancy. This unusual excessive vomiting is known as hyperemesis gravidarum, a serious medical condition that may require hospitalization. Read on to find out how to distinguish HG from morning sickness and what you can do to manage it.

What is hyperemesis gravidarum?

Hyperemesis gravidarum literally translates to "excessive vomiting of pregnant women." It is a condition characterized by excessive nausea, vomiting, and weight loss and electrolyte imbalance. HG is an uncommon complication of pregnancy, with just about 3% of pregnant women affected by it, according to BabyCentre.co.uk.

HG symptoms usually begin between the fourth and seventh weeks and eases off between the 14th and 16th weeks. Symptoms usually disappear by the 28th week, although it may last for the whole pregnancy for 10 to 20% of women suffering from HG.

What causes hyperemesis gravidarum?

The absolute cause of HG is still unknown, although experts believe it may be caused by a rise in hormone levels. The Cleveland Clinic identified these hormones as most likely to be estrogen and HCG (human chorionic gonadotropin).

How is HG different from morning sickness?

According to the Cleveland Clinic, a pregnant woman may possibly have HG if she has the following symptoms:

  • vomiting for more than three times a day;

  • weight loss of more than 10 pounds;

  • dehydration; and

  • dizziness and lightheadedness.

Other symptoms include food aversions, decreased urination, loss of skin elasticity, jaundice, headaches, extreme fatigue, confusion, fainting, low blood pressure, rapid heart rate and depression.

The table below adapted from the American Pregnancy Association summarizes how hyperemesis gravidarum is differentiated from morning sickness:

Morning Sickness

Hyperemesis Gravidarum

  • nausea sometimes accompanied by vomiting
  • nausea subsides by the 12th week or soon after
  • vomiting does not cause severe dehydration
  • vomiting that allows food to stay down
  • nausea accompanied by extreme vomiting
  • nausea does not subside
  • vomiting causes severe dehydration
  • vomiting does not allow any food to stay down

Will hyperemesis gravidarum harm the baby?

Research shows that fetal complications resulting from HG are subtle or uncommon, according to the H.E.R. Foundation, an organisation that conducts research and education on HG. Most complications are associated with mothers who have lost more than 10% of their body weight and have failed to gain more weight before they gave birth. Complications may also result if treatment is inadequate or delayed.

Thus, if you're given early medical care to manage your symptoms and ensure that you're not deficient in nutrients, then it's less likely that the baby will be harmed.

What are the risk factors for developing hyperemesis gravidarum?

A pregnant woman may have an increased probability of developing HG if

  • she's had HG during her previous pregnancy;

  • her mother or sister had HG during their pregnancy;

  • she's having twins or triplets;

  • it's her first pregnancy;

  • she's prone to migraines or travel sickness;

  • she's overweight; or

  • she has a pre-existing liver disease.

How is hyperemesis gravidarum treated?

Treatment will depend on the severity of HG symptoms. In some cases, HG may be mild enough that preventive measures are enough to curb the symptoms.

The Cleveland Clinic suggests the following steps to prevent morning sickness from becoming severe:

  • Use pressure point wrist bands, taking vitamin B6 or eating ginger

  • Eat small, frequent meals

  • Eat bland foods

  • Wait for nausea to improve before taking iron supplements

However, in most cases HG becomes so severe that it requires hospitalization. Hospital treatment for HG usually includes intravenous fluids in order to replace the fluids lost from vomiting and tube feeding to curb maternal malnutrition.

Are there ways to ease the symptoms of hyperemesis gravidarum?

Ways to lessen and cope with symptoms of HG include:

  • Take small sips of fluid or suck on ice cubes to stay hydrated.

  • Avoid sights and smells that trigger your nausea. Eat cold foods if cooking makes you nauseous.

  • Eat what you can manage and don't worry about what you're eating. Your baby will get the nourishment it needs from your body's reserves.

  • Get as much rest as possible; fatigue can make nausea and vomiting worse.