Illness in pregnancy ... Always see a doctor if you're concerned about any aspects of your health or wellbeing while pregnant.

Illness in pregnancy ... Always see a doctor if you're concerned about any aspects of your health or wellbeing while pregnant.

What is it?
Hyperemesis gravidarum is a pregnancy complication in which hormonal changes - especially increased levels of oestrogen and human chorionic gonadotropin (hCG) - lead to acute, long lasting morning sickness. General morning sickness usually ends before or at the start of the second trimester, when these hormone levels start to drop, but for some woman the levels stay elevated, meaning they can suffer for months, or even throughout their entire pregnancy.

It's not known why some women are affected while others aren't, but certain women are more predisposed to suffering from hyperemesis gravidarum, including those who:

  • are expecting two or more babies
  • have a family history of hyperemesis gravidarum, or who have had it in a previous pregnancy
  • suffered from motion sickness or travel sickness prior to pregnancy
  • have other medical conditions, especially those with hyperthyroidism, gestational diabetes and liver issues.

According to the Royal Australian College of General Practitioners, it's thought that between 0.3 and 1.5 percent of pregnant women will experience hyperemesis gravidarum.

What are the symptoms?
Expectant women with hyperemis gravidarum can experience severe nausea and vomiting that lasts for months. The bouts of nausea can be triggered by a number of factors, including hunger, fatigue, taking prenatal vitamins, and smelling and eating certain foods, particularly those that are oily, high in fat or acidic. If left untreated, this can lead to dehydration, malnutrition and weight loss. It can also cause:

  • slowed metabolism
  • increased heart rate
  • bloodshot eyes
  • stress and depression
  • heartburn
  • reflux
  • stomach ulcers
  • constipation
  • ketosis
  • deep vein thrombosis
  • hallucinations
  • low birth weight in the baby
  • premature birth.

What's the treatment?
The first step in treating hyperemesis gravidarum is to try the regular morning sickness remedies, including taking pregnancy-safe anti-nausea medication.

Most pregnant women who have difficulty ingesting and keeping down any food will be admitted to hospital, where they'll be rehydrated through an IV to replace lost electrolytes and vitamins, as well as being given sustenance intravenously.

Does it affect the baby?
Fortunately, the foetus won't be affected unless the nausea and vomiting goes untreated for an extremely prolonged amount of time. The majority of babies will get the nutrients they need from the reserves stored in their mother’s body - even if this means her teeth and bones will become brittle, and her hair and skin will become dry and dull, when the nutrients needed to restore them aren't being replenished through food.

Other issues
Hyperemesis gravidarum can make sufferers unable to do even the most basic of daily activities, such as showering, going to work or looking after family members. This makes many sufferers feel depressed and unhappy to be pregnant. These feelings have the potential to develop into postnatal depression, so it's a good idea to seek support with counselling or see a doctor for anti-depressants.

Facts verified by Dr Raewyn Teirney. Dr Raewyn Teirney is gynaecologist, obstetrician and fertility specialist and a visiting medical officer at the Royal Hospital for Women in Sydney, and also consults from her private rooms at Maroubra and Kogarah.

For pregnancy support, check out the discussions in the Essential Baby forum. You can also join a group of women who are due at the same time as you.