Nausea and vomiting during pregnancy is considered a classic symptom. But sometimes, these last the whole time of gestation … This is called hyperemesis of pregnancy. What is it exactly?
Feeling sick and vomiting early in your pregnancy, a classic? Women who suffer from this symptom experience very difficult first months. But some experience this effect of NVG (nausea and vomiting of pregnancy) throughout gestation. It then takes another name: this is hyperemesis of pregnancy. How is it explained?
Hyperemesis of pregnancy is also called “uncontrollable vomiting”. They can last longer than the first trimester and go until the end of the pregnancy. They are not benign but “associated with an increase in maternal and fetal morbidity”, highlighted a study published by the CNRS.
What are the specific symptoms of hyperemesis?
Several symptoms make it possible to suspect hyperemesis of pregnancy. Uncontrollable vomiting (up to 50 times a day) despite treatment and without visible aetiology, complete aversion to food and drink, dehydration, weight loss of at least 5% compared to the initial weight, fluid and electrolyte disturbances, ketonuria signifying acute undernutrition, hyper salivation with spitting, a increased sense of smell.
Cardiac or hepatic disturbances may be observed. Of course, associated with all of these symptoms is vitamin loss, exhaustion, and depression.
What is the proportion of women affected?
It is estimated that approximately 0.3% to 3% of pregnant women have hyperemesis pregnancy. Each year in the United States, 500,000 patients are hospitalized for this reason. The pathology has led to deaths but is now taken care of, in order to compensate for the deficiencies caused by vomiting.
What are the causes of hyperemesis?
Certain unknowns persist when it comes to the physiological causes of hyperemesis. But several hypotheses have all the same been formulated, in particular from the point of view of hormones. The intensity of this common symptom of early pregnancy is linked to a spike in hCG hormones. It is believed that the pregnancy hormone may have a tendency to bind to receptors for the hormone TSH (which stimulates the thyroid) and lead to exacerbation of pregnancy-induced vomiting. In addition, the estradiol level is much higher in women with hyperemesis, according to another study. Another observation relates to the increase in thyroid hormones.
Two other potential explanations were presented. The first would be to bacteriological type : a study highlighted that patients presented in large numbers the bacterium Helicobacter pylori. Another hypothesis relates to the psychology of the patients, which can also play a role.
An American study points to the potential role of two genes in pathology: GDF15 and IGFBP7. They are both involved in the manufacture of the placenta, appetite and asthenia (chronic fatigue syndrome).
How is hyperemesis of pregnancy managed?
The association dedicated to the disease underlines the lack of recognition of this pathology in France. It still begins to be revealed, thanks to personalities who suffered from it during their pregnancy, such as Kate Middleton or American actress Amy Schumer.
However, associations fight to make it known and are associated with medical “toolboxes”, of the Mapatho type to advise patients on essential supports. Are listed contacts of expert caregivers on the issue, the list of associations that can provide answers on the disease, or digital tools to support daily ailments.
Sources: Association for the fight against hyperemesis of pregnancy, press release 2/12/2020.
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