Nausea and vomiting are classic symptoms of pregnancy. But for some pregnant women, these manifestations are much more severe. What is hyperemesis gravidarum? What are the causes ? How to treat it? What to eat? The answers of Anh-Chi Ton, midwife.
L’hyperemesis gravidarum is a very serious and severe pathology that concerns pregnancy. Still “rather poorly known”the management around this disease was until now “still not codified”, reported Cyril Huissoud, gynecologist-obstetrician and secretary general of the National College of French Gynecologists and Obstetricians (CNGOF) during a press conference reported by AFP. But recently, the CNGOF presented new recommendations for better management of pregnant women suffering from hyperemesis gravidarum.
What is hyperemesis gravidarum?
Hyperemesis gravidarum, or hyperemesis gravidarum, refers to nausea perms and vomiting that you can’t hold back. We understand it better by looking at the etymology of this term in Greek: hyper means “excess”, emesis means “vomit” and gravid “pregnancy”. “It has nothing to do with the nausea and vomiting that most pregnant women suffer from from time to time. There it is really all day, and sometimes until childbirth“explains the midwife.
When does hyperemesis gravidarum start?
These intense nausea and vomiting, which affect 0.3% to 3% of pregnant women, generally begin around 8 SA, i.e. six weeks of pregnancy. But where classic nausea stops around the third month, hyperemesis gravidarum can last until the child is born.
What are the symptoms of hyperemesis gravidarum?
Hyperemesis gravidarum results in very intense nausea and frequent vomiting. Some future mothers testify to having vomited up to 50-60 times in a day. Contrary to classic pregnancy nausea which most often occurs in the morning, women who suffer from hyperemesis gravidarum do not know any respite and vomit from morning to evening. The pathology also results for some women in a hypersalivation, abdominal pain, acid reflux. Still taboo a few years ago and little considered, we talk a lot more about this disease since the Princess of England Kate Middleton confided that she suffered from hyperemesis in each of her three pregnancies.
What are the causes of hyperemesis gravidarum?
“Several hypotheses have been put forward to explain it but we do not know the causes with precision. This pathology is for example more frequent during a twin pregnancy, it is thought that it could also be linked to a thyroid problem.“adds Anh-Chi Ton. A study conducted at the University of California in 2018 and published in the journal Nature Communications advanced the hypothesis ofa genetic cause to explain hyperemesis gravidarum. The genes, called GDF15 and IGFBP7 are both involved in the development of the placenta and play an important role in the onset of pregnancy and the regulation of appetite. Variations in these proteins are associated with extreme nausea and vomiting. The CNGOF also proposes that “The initial assessment of the severity of nausea and vomiting during pregnancy is based on 3 clinical criteria: weight loss in relation to weight before pregnancy (greater than or equal to 5%)the search for clinical signs of dehydration and the modified PUQE score (Pregnancy Unique Quantification of Emesis and nausea) (greater than or equal to 7).
The management of hyperemesis gravidarum is twofold. “It happens that we are obliged to hospitalize the patient for rehydrate her with an infusion. We can also give him a antiemetic treatment to calm the vomiting, vitamins“, explains the midwife. The objective will also be to control weight loss and ensure the baby is growing well. In addition to these different treatments, the mother-to-be can also observe certain lifestyle and dietary measures: split meals, rest as much as possible, eat a little before getting up in the morning and never fast.
What are the consequences of hyperemesis gravidarum?
Hyperemesis gravidarum can have a severe impact on the body and have serious consequences: fetal growth retardation, premature delivery, gestational diabetes, high blood pressure, low birth weight, caesarean section. “This pathology causes weight loss of at least 5% compared to the initial weight, asthenia, extreme fatigue, sleep problems, irritability, low blood sugar“, details the specialist. “A blood ionogram is prescribed, which corresponds to the dosage of the main ionic constituents of the blood, and an ionic imbalance can then be observed. We are no longer here in simple nausea but in the face of. a real pathology“, explains Anh-Chi Ton.
Hyperemesis gravidarum with each pregnancy: what to eat?
It is very common for a woman who suffered from hyperemesis gravidarum in her first pregnancy to suffer from it again in subsequent pregnancies. Unfortunately, it is not possible to prevent the onset of the disease. On the food side, the pregnant woman who is affected by hyperemesis gravidarum often has a lot of trouble eating. Despite everything, it is important for his health but also that of his baby to continue to eat and stay hydrated on a daily basis. For this, it can turn to anti-nausea foods, rich in carbohydrates such as fruits (banana, orange, tangerine), rice, cereals (rusks, oats, rye bread) and potatoes, which generally alleviate these inconveniences. Avoid: Foods high in fat. For drinks, water is preferred or lemon water, to be drunk in small quantities throughout the day.
Thanks to Anh-Chi Ton, midwife
Source: Formalized consensus of CNGOF experts: management of nausea and vomiting during pregnancy and hyperemesis gravidarum