Your GP can treat you for normal nausea and vomiting in pregnancy.
If you start to experience extreme nausea and vomiting, and are unable to keep down fluids, your GP or midwife can refer you to our Jasmine Unit.
We will assess whether you have a condition called hyperemesis gravidarum (HG).
About hyperemesis gravidarum (HG)
Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy.
Nausea and vomiting in early pregnancy are common. When the nausea and sickness mean that you cannot keep food or liquid down, this condition is called HG.
It may start as early as week 6 of pregnancy and continue for several weeks after that. It usually improves by week 12 or week 14.
It may continue throughout pregnancy, but this is rare. It can also happen again in future pregnancies.
Importance of treatment
If HG is not treated, it can become serious, because you are not getting enough nutrition for yourself or your baby.
If we do not treat HG, you may be at risk of the following:
- lack of vitamins
- malnutrition (poor nutrition) and weight loss
- severe dehydration, which can cause:
- deep vein thrombosis (DVT means a blood clot in a deep vein, often the leg)
- pulmonary embolism (a clot in the lung)
- low levels of electrolytes, which can affect heart rhythm and cause general weakness. (Electrolytes are essential minerals and salts found in blood and body fluids.)
- small tears in the tissue of your gullet (food pipe)
- low mood or depression.
It can also affect your ability to do everyday tasks, work or look after your children.
Causes
The causes are unknown, but it may be linked to the following:
- the usual pregnancy hormonal changes
- a change in thyroid hormone levels. (The thyroid produces hormones that control your metabolism, energy levels and growth.)
- emotional factors
- family history
- twin pregnancies
- a rare condition called 'molar pregnancy', where the baby does not survive.
Symptoms
The symptoms can include any of the following:
- prolonged and severe nausea and vomiting (more than 3 or 4 times a day)
- inability to keep down food or water
- weight loss
- excessive tiredness or dizziness, or fainting
- passing more concentrated urine, and less urine than usual
- headaches
- palpitations (racing, fluttering or irregular heartbeat)
- blood in the vomit
- excessive saliva, or inability to swallow saliva
- pale and dry skin.
Treatment
When you are first referred will ask you to come to the Kingston Hospital Jasmine Unit 2 or 3 times a week. This is so we can give you dehydration and anti-sickness treatment.
When you arrive
Urine test
We routinely test the urine of everyone who needs treatment for HG. We do this to see if their urine contains ketones. Ketones indicate severe dehydration in patients with HG.
Ketones are a waste product that the body produces when you are not able to eat and drink normally.
When you eat and drink normally, your body processes the food and turns it into sugar. If you have severe vomiting and dehydration, your body has to find different sources of sugar and this process produces ketones.
We will also test your urine for possible urinary infection.
Blood test
We may also give you a blood test to check for electrolyte (minerals and salts) imbalance.
Types of HG treatment
For dehydration
We will give you fluids into a vein (intravenously) to correct your dehydration.
You can stop coming into Jasmine Unit when you no longer need intravenous fluids.
For sickness
There are several anti-sickness medications that we can give you, either on their own or in combination.
We usually start by giving you one of these medications as an injection. You can change to tablets when you start to feel better, and you can keep taking these tablets at home.
These medications are known to have no ill effects on your baby.
We recommend that you keep taking the medication(s) regularly, rather than waiting to see if you become nauseous first.
Your GP can give you repeat prescription(s).
If you are prescribed more than one anti-sickness medication, you may find it helpful to take them at different times during the day.
When to seek urgent medical help
Important
Go to your nearest Emergency Department (A&E) if you experience any of the following:
- palpitations (racing, fluttering or irregular heartbeats)
- dizziness
- fainting.
Contact information
Kingston Hospital Jasmine Unit
Telephone: