How do I know the difference between
severe or constant morning sickness or hyperemesis gravidarum?
What is the difference between severe morning sickness and
hyperemesis gravidarum?
Women often ask if they have hyperemesis gravidarum (HG)
or just a bad case of morning sickness. Early in pregnancy,
it may be difficult to know because HG develops over time.
If you find yourself losing weight rapidly (1-2 pounds
[0.45-0.9 kgs.] a week or more) due to severe nausea and
vomiting, you need to find
a health professional who
is familiar and comfortable caring for a woman with HG.
Sometimes a bad case of morning sickness will progress
to HG due to ineffective or inadequate care. Delaying treatment
is far too common to avoid any risks to the mother and
child. However, many medications have
been used for many years and the data shows little if any
increase in risk to the unborn child, even if taken early
in pregnancy. The risk of dehydration, ketone production,
malnutrition, and rapid weight loss are likely greater
than the risk of harming the unborn child with medications.
The following chart illustrates the difference in severity
between morning sickness and HG. Significant (>5% of
your pre-pregnancy weight) weight loss and recurrent dehydration
are classic signs of HG that most health professionals
recognize.
You lose little if any weight.
|
You lose 5-20 pounds or more. (> 5% of prepregnancy
weight)
|
Nausea and vomiting do not interfere with your ability
to eat or drink enough each day.
|
Nausea and vomiting cause you to eat very little and get
dehydrated from vomiting if not treated.
|
You vomit infrequently and the nausea is episodic but
not severe. It may cause discomfort and misery.
|
You vomit often and may vomit bile or blood if not treated.
Nausea is usually moderate to severe and constant.
|
Dietary and/or lifestyle changes are enough to help you
feel better most of the time.
|
You will probably require fluid hydration through a vein
and/or medications to stop the vomiting.
|
You typically will improve gradually after the first trimester,
but may be a little queasy at times during the remainder of your pregnancy.
|
You usually feel somewhat better by mid-pregnancy, but
you may continue to be nauseous and/or vomit until late pregnancy.
|
| You will be able to work most days and care for your family. |
You will likely be unable to work for weeks or months,
and may need help caring for yourself. |
Every woman with HG loses weight. Calculate the percentage you have lost to see if you should call your doctor.
| 1 week |
1-2% |
> 2% |
| 1 month |
5% |
> 5% |
| 3 months |
7.5% |
> 7.5% |
| 6 months |
10% |
> 10% |
Reprinted from Blackburn GL, Bistrian
BR, Maini BS, Schlamm HT, Smith MF. "Nutritional and metabolic assessment
of the hospitalized patient." JPEN. 1977; 1:11-22.
* Percent Weight Change = [(Usual Weight - Actual Weight) ÷ (Usual
Weight)] x 100
NOTE: This scale is based on non-pregnant
subjects. |
