Excessive Nausea and Vomiting in Pregnancy

Bukola was 6 weeks pregnant and worked at the Lekki branch of a retail bank. This was her first pregnancy. She covered the customer service desk. The bouts of retching, nausea, and vomiting often disrupted her day. She couldn’t keep her meals down. In fact, tiredness, dizziness, dry mouth, and a heavy pounding in her chest were quite common in this period.

On more than one occasion on her way to work, she would have to get off at the Lekki Admiralty Bustop to throw up before getting to the office. It got so bad sometimes she would faint at work and would have to be rushed to the hospital. This was followed by several days on admission and time off work.

Bukola was experiencing was a rare condition known as “Hyperemesis Gravidarum (HG).

“Hyperemesis Gravidarum (HG) is the most severe form of nausea and vomiting in pregnancy”. HG leads to dehydration, disruptions in metabolic and electrolyte imbalances as well as weights-loss.

Ogunyemi, Fong, Isaacs et al. Hyperemesis Gravidarum. Emedicine Medscape. 2017 Jan. Emedicine

What causes it?

The exact cause of hyperemesis gravidarum is unknown. Interestingly, several theories suggest that the following may be at play:

• The effect of a combination of genes in a mothers DNA
• Hormonal changes in pregnancy
• The liver and gut not functioning as they should.
• Changes in a mother’s sense of smell during pregnancy
• A stomach infection with a bacteria called H. Pylori

Who then is at risk?

• If you are a first time mum,
• have ever had hyperemesis gravidarum (HG) in your previous pregnancies,
• you are pregnant with more than one baby ( a set of twins, triplets etc)
• or you have a tumour in the womb associated with pregnancy (trophoblastic disease) you are predisposed to having this hyperemesis gravidarum

For some mums, nausea and vomiting resolve after the first trimester. However, some mums go on to struggle. They are often in and out of the hospital till they finally give birth to their babies.

You should visit the hospital in the following situations:

• if ever the bouts of vomiting don’t stop and you can’t hold even sips of fluid down,
• you feel constantly dizzy, disoriented and unable to focus
• and your heart is pounding (i.eyou become aware of your heartbeart)

Eventually, you may need to be admitted. Subsequently, you may be given fluids and medication to correct the imbalances caused and to stop thevomiting.

Finally, no matter the cause of your hyperemesis gravidarum, it’s bound to take its toll.

The implications…..

financial (health bills), physical (weakness, weight-loss, poor appetite), and logistical (work interruptions, having to make arrangements to get to and fro or stay in hospital); can leave a mum frustrated or feeling bad about herself.

Know this…. no matter how many times you have to be admitted for care, or stay home from work, having HG does not mean you are lazy or weak as a mum… it happens to the best of us.