Hyperemesis Gravidarum

WHAT YOU SHOULD KNOW:

• Hyperemesis (heye-per-EM-e-sis) gravidarum (gra-vi-DA-rum) is a severe form of nausea and vomiting that happens during pregnancy. Hyperemesis is worse than morning sickness. It may cause a woman to have nausea or vomiting all day for many days. It may keep a woman from eating and drinking enough food and liquids. Hyperemesis may lead to problems such as weight loss, dehydration, and malnutrition. Malnutrition occurs when you do not get enough calories or nutrients to keep you healthy. Women who have hyperemesis may also have trouble doing their regular daily activities.
  
  
• Hyperemesis usually occurs during the first half (the first 20 weeks) of pregnancy. It often goes away once a woman is in her second half of pregnancy. However, sometimes hyperemesis continues through an entire pregnancy. The cause of hyperemesis is not known. Some of the signs and symptoms are severe (very bad) nausea and vomiting. This may lead to problems such as weight loss and dehydration (loss of too much body fluid and salts). Always work closely with your caregiver to find the treatment that is right for you. Your treatment will depend on how your hyperemesis is affecting you. You may need to be treated in the hospital if you cannot control your hyperemesis at home.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Hyperemesis may cause you to lose too much weight. Vomiting caused by hyperemesis may damage or tear the tissue in your esophagus. It may cause you to lose too much water and electrolytes (salts) from your body. If this happens, you may need to go to the hospital to get IV fluids. Hyperemesis may cause other chemicals in your body to be unbalanced. Severe hyperemesis may cause your baby to have a low birth weight (weigh less than he should at birth). Without treatment, hyperemesis gravidarum can lead to malnutrition and damage to body organs such as the kidney and liver. It can even cause death. Always work closely with your caregiver to treat your hyperemesis.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Call button:

You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.

Tests:

Your caregiver will do a medical exam. Your caregiver may ask you questions about your health and the medicines that you are taking. Caregivers may do tests to find out if the vomiting you have is caused by a different health problem. Your caregiver may do tests to find out if your hyperemesis is causing other problems.

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• External fetal heart monitoring: Caregivers may use this to monitor your baby's heartbeat, and the contractions of your uterus. A small metal disc (monitor) with gel on it is placed on your abdomen. A belt will be fastened around your waist to hold the monitor in place. The monitor may need to be moved as your baby moves inside you. It may also be put on and taken off, or left in place. The monitor is attached to a machine with a TV-type screen, or a printer. The screen or the paper print out shows a tracing of your uterus contracting, and the baby's heartbeat.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.
  
  
• Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to a TV-like screen.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Treatment:

You may need one or more of these treatments.

• NPO: NPO means that you will not be given anything to eat or drink by mouth. If you are not able to keep liquids or foods in your stomach you may be NPO for a certain period of time. When it is time to begin eating again, you will start slowly. You will be given small, bland meals to see if you can handle them. Then caregivers may slowly begin giving you other foods.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• TPN: TPN stands for total parenteral nutrition. It is also called hyperalimentation. It provides your body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). TPN is used when you have problems with eating or digesting food. TPN is usually put into your body through a large IV catheter, such as a central line. You may need TPN for several days or longer.

Medicines:

Your caregiver may give you one or more of the following medicines and nutrition supplements.

• Vitamin B6: This vitamin may be given to help decrease nausea and vomiting.
  
  
• Antihistamine: An antihistamine (an-ti-HIS-tah-meen) may be given along with Vitamin B6 to help decrease nausea and vomiting.
  
  
• Antiemetic medicine: An antiemetic (an-teye-e-MET-ik) may be given to calm your stomach and control vomiting.
  
  
• Sedative: This medicine is given to help you stay calm and relaxed.
  
  
• Vitamin and mineral supplements: Caregivers may give you vitamin or mineral supplements to increase the level of vitamins and minerals in your body. Vitamins and minerals may be given in your IV, as a shot, or by mouth.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hyperemesis Gravidarum (Inpatient Care)