Note : Dr.Neelima Mantri is now available only at Bombay Hospital & Research Centre and Nanavati Hospital

Hyperemesis

Hyperemesis In Pregnancy

Hyperemesis or morning sickness is a condition of nausea and vomiting in pregnancy. It is seen in the first trimester and usually subsides n the second trimester, though few mothers can continue to have nausea till late in the pregnancy. Although more common in the morning hours, it can occur at any time. The most suggested hypothesis for its cause is excessive hormones of pregnancy. Some patients have increased sensitivity to the pregnancy hormone human Chorionic Gonadotrophin (hCG), whereas stress can act as an additive factor in a few women. Prolonged hours of starvation aggravate the situation, so also beverages like tea, coffee or aerated drinks. Suggested dietary modifications which could prove of help are as follows: Eat short frequent meals, preferably every 2 hourly, as starvation is not helpful Have lots of fluids, water, coconut water to replenish the water and mineral losses Have substantial food before going to bed at night, or some biscuit in the middle of the night, if you wake up for some reason Reduce or avoid drinks like tea, coffee or aerated beverages Take a dry toast or a biscuit just after you wake up in the morning Avoid stress, try to stay relaxed Avoid foods that you don’t like Do Not Take Any Medications To Relieve The Vomiting Without Doctor’s Advice. Any medications consumed in initial weeks of pregnancy have a potential to harm your baby. Treatment: Proper counseling, supportive care and following the food advice certainly assist in the treatment. Medications are required in a good number of patients. Some patients with severe symptoms do require hospitalisation and intravenous medicines and fluids. It is advisable not to neglect the symptoms to avoid dehydration and electrolyte disturbance. Pregnancy Induced Hypertension It is a condition seen in pregnancy, usually in the late second or early third trimester, wherein there is a rise in the blood pressure of the patient. It is a serious disorder in pregnancy and can cause maternal and/or fetal death in 2-4% cases. It can also occur in women who had high BP prior to pregnancy. The symptoms may not occur till late in the disease, therefore it is advised to undergo proper ante natal visits to the obstetrician with a regular check of the blood pressure. The symptoms that could occur are excessive weight gain and swelling of hands and feet, later as the disease advances there could be headache, blurring of vision, abdominal pain or dizziness. These symptoms should not be neglected, but appropriate medical help should be sort for.

Mother Complications

  • Kidney damage, loss of vision
  • Convulsion or fit
  • Severe breathing difficulty
  • Uncontrolled bleeding from any site
  • Need of blood or blood products
  • ICU admission and ventilatory support
  • Maternal death

Fetal

  • Low birth weight, premature delivery
  • Birth asphyxia
  • Fetal death due to premature placental separation

Management

There is no treatment of this condition, except immediate delivery. The blood pressure can be controlled and pregnancy can be prolonged till the time baby becomes mature enough to deliver by certain medications. Early signs of the worsening of the disease should be picked up correctly and be acted upon. Treatment and control of complications is essential.