More than morning sickness: Hyperemesis Gravidarum in pregnancy
Many women expect some level of nausea or vomiting during pregnancy—commonly referred to as "morning sickness." However, for around one in every 100 pregnancies in Australia, nausea becomes severe enough to profoundly impact daily life. This condition, known as Hyperemesis Gravidarum (HG), goes far beyond typical pregnancy nausea and requires careful attention and support.
What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum is characterised by extreme nausea and persistent vomiting that usually begins within the first four weeks of pregnancy and often continues until between 13 and 20 weeks. Unlike typical morning sickness, HG can severely limit a woman’s ability to eat and drink normally, dramatically affecting physical and emotional wellbeing.
Left untreated, HG can lead to significant weight loss, severe dehydration, vitamin deficiencies, and even serious health complications for both mother and baby. Therefore, recognising and managing symptoms early is essential.
Why do some women develop HG?
The exact causes of HG aren't fully understood, but certain factors seem to increase risk:
First-time pregnancy
Pregnancy with multiples (e.g., twins or triplets)
Young maternal age
Overweight or underweight before pregnancy
High-fat or low-dairy dietary patterns
Emerging research also suggests that higher levels of certain hormones, like GDF15, may trigger or exacerbate HG symptoms.
Identifying HG: more than just morning sickness
How can you tell the difference between regular morning sickness and HG? Health professionals often use tools like the PUQE (Pregnancy-Unique Quantification of Emesis) scoring system to assess symptom severity. Signs that you may have HG rather than typical nausea include:
Severe, frequent vomiting
Inability to keep food or fluids down
Significant weight loss
Reduced ability to perform daily activities due to nausea
If you recognise these symptoms, it's crucial to speak with your GP or obstetrician promptly.
Nutritional strategies for managing HG symptoms
While severe cases may require medical interventions—such as anti-nausea medications or intravenous fluids—nutritional approaches can also offer significant relief. Here are some targeted dietary strategies:
Vitamin B1 (Thiamin)
Frequent vomiting in HG can lead to low levels of vitamin B1, essential for nervous system health and energy production. Deficiency can cause severe neurological complications. Aim for the recommended 1.4 mg/day by including foods like fortified cereals, legumes, nuts, and lean meats in your diet.
Vitamin K
Vitamin K is crucial for proper blood clotting and helps prevent complications such as foetal brain haemorrhage, which can occur in cases of severe HG-induced malnutrition. The recommended intake for pregnant women is 60 µg/day, found in leafy greens like spinach and kale.
Protein-rich meals
Eating small, frequent meals rich in protein can significantly ease nausea by slowing digestion and stabilising blood sugar levels. Protein also supports muscle and tissue growth essential during pregnancy. Recommended daily protein intake ranges from 46 grams in the first trimester to 60 grams in later pregnancy stages.
Practical tips to ease nausea
Small, frequent meals: eating smaller portions more often can be easier on your stomach.
Focus on tolerable foods: choose bland, easy-to-digest foods without strong smells or flavours.
Ginger: numerous studies highlight ginger’s effectiveness in reducing pregnancy-related nausea and vomiting—try ginger tea or fresh ginger in your meals.
Stay hydrated: electrolyte-rich drinks or small sips of fluids throughout the day can help maintain hydration.
Emotional and social support
Experiencing HG can be isolating. Emotional support from family, friends, or professional counselling can be invaluable. Connecting with others who have experienced HG through support groups or online forums can also provide practical advice and reassurance.
Understanding HG and recognising it early allows you to access appropriate care and support. If you're experiencing severe nausea or vomiting, don't hesitate to seek medical help—your health and your baby's health depend on it.
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