What is HG?

Do you need support?

If you, or someone you know, is suffering from NVP or HG and you’d like some support please get in touch.

 

Hyperemesis Gravidarum (HG) is a complication of pregnancy in which sufferers experience extreme levels of nausea and vomiting. Unlike regular ‘morning sickness’, which is considered a normal or even welcome sign of early pregnancy, HG is not at all normal. Regular pregnancy sickness affects around 70-80% of pregnancies and often goes away after the first trimester. HG is a far more severe condition and can be potentially life-threatening if left untreated.

The hardest, and most challenging, parts of Nausea and Vomiting in Pregnancy (NVP) and HG are dehydration and malnutrition. Sufferers may find themselves admitted to the hospital for treatment and to prevent their condition from worsening. Many more need to take extended periods of time off work to manage their nausea and vomiting. This can result in loss of income, if not total loss of employment, making an already stressful situation much worse. There are a number of different physical effects of prolonged vomiting, and inadequate eating and drinking, and can include esophageal tearing, ulcers, reflux, weight-loss, exhaustion, constipation and more.

Living with severe levels of nausea and vomiting has a profoundly negative impact on a person’s health and wellbeing, both physically and mentally. There is still widespread ignorance of HG and a lack of understanding for people with the condition. Stigma surrounds the use of medication in pregnancy - a vital option for many sufferers - leading to guilt, shame and prolonged physical suffering for those who are refused treatment.

HG can be an incredibly isolating condition: many sufferers are left bedridden or, at least, housebound for months on end. Add in the shame and guilt from seeking treatment, missing work or neglecting chores to the disbelief many face from friends and family, and the physical and mental strain of this situation can take a toll. The effects may even be felt for months or years after birth.

Morning Sickness or something more serious?

Early in pregnancy, it may be difficult to know whether you’re experiencing Morning Sickness or the more serious NVP or HG because these conditions can take time to fully develop. If you find yourself dehydrated and/or losing weight rapidly due to severe nausea and vomiting it’s time to seek help from a healthcare professional. We can help you find one if your current care team don’t seem knowledgeable in the condition.

Sometimes morning sickness will progress to HG due to ineffective or inadequate care. Practitioners not experienced in dealing with HG sufferers, or those not aware of the most recent treatment recommendations, may delay treatment far beyond what is necessary. This sets the sufferer up for having to deal with complications and increased suffering due to chronic dehydration and malnutrition. Get in touch if you feel your condition is not being taken seriously or you feel treatment is being withheld.

Morning Sickness

You lose little if any, weight

Symptoms don’t impact your ability to eat/drink normally

You vomit infrequently and the nausea is episodic but not severe or constant

Traditional remedies like diet or lifestyle changes are enough to help you feel better most of the time

You typically improve after the first trimester but may have brief periods of nausea later in pregnancy

You will be able to work most days and care for your family, though less than usual at times

You may feel a bit depressed at times, especially if you have more severe nausea, but are able to be your usual self most of the time. You will likely forget most of the unpleasantness after delivery

Hyperemesis Gravidarum

You lose 2-10 kilos or more.

Symptoms are so severe you are unable to eat/drink normally

You vomit, or feel the need to, often and may vomit bile or blood. Nausea is usually moderate to severe and constant

You will probably require fluid hydration through an IV and/or medications to ease your symptoms

You usually feel some relief by mid-pregnancy, but may be nauseous and/or vomit until late pregnancy/delivery

You will likely be unable to work for weeks or months and may need help just caring for yourself

You may feel anxious about what lies ahead if you had HG before. You will likely become depressed due to the isolation and physical discomfort. More severe HG often is traumatic and may impact you for years to come

What causes HG?

Our American sister organisation, The HER Foundation, are the leaders in research on this topic. According to their website, there are numerous theories regarding the cause of HG; however, none are, as of yet, conclusive. A cause is very difficult to determine and is most likely not due to only one factor. It may vary between people depending on biological make-up (genetics), body chemistry, and overall health. 

They go on to say that most of the current theories centre around known pregnancy-related factors like hormonal changes (e.g. estrogen increase) and physical changes (e.g. relaxed esophageal sphincter) since the onset is related to pregnancy and ends before or at delivery. Research is limited and minimal funding is granted for hyperemesis research, so high-quality studies with decisive results are uncommon. If you’d like to read more about the existing research here is a list of links from HER. 

  • Psychological Causes
    Some mistakenly state psychological causes, but most if not all sufferers experience psychological effects (e.g.: frustration, feelings of helplessness, isolation, depression, etc.) secondary to HG

  • Thyroxine Levels
    Increase in serum thyroxine levels have been documented in 70% of pregnancies complicated by HG

  • Gastric Neuromuscular Dysfunctions
    A recent theory cites a dysfunction that results in regurgitation of duodenal content back into the stomach and subsequent nausea and vomiting

  • Deficiencies of Nutrients
    Another theory attributes HG to deficiencies of pyridoxine and zinc, though results are not conclusive

There are also studies being conducted that suggest the placenta and appetite genes GDF15 and IGFBP7 are associated with Hyperemesis Gravidarum. For more information read this piece by our UK sister organisation Pregnancy Sickness Support.