Hyperemesis Gravidarum and Its Treatment

February 28, 2023

More serious than morning sickness, hyperemesis gravidarum is severe nausea and vomiting during pregnancy. Patients can feel dizzy when standing, due to loss of fluids and electrolytes. Hyperemesis gravidarum can lead to malnutrition and dehydration, so it is important to treat it effectively as soon as possible.

The Lamaze organization has several dietary suggestions for getting enough nutrition and fluids. The old saying about eating pickles and ice cream when you feel like it might make sense. Food aversions can be so intense that eating what you want when you feel like it can help to counteract the effect of avoiding so many things that just don’t appeal. Cold or frozen foods and beverages, having less aroma and flavor, can be less nauseating than foods you can easily smell and taste. Making smoothies and sipping them slowly can help you pack some nutrition into a liquid that you can ease into your stomach without upsetting it. The same goes for solid foods—eat small bites.

Eating on a regular schedule can help keep an empty stomach from triggering feelings of nausea. High calorie, high protein, high vitamin foods help to provide all that’s needed to nourish mom and baby. Many mothers find that bland, dry foods such as crackers, or sugary foods or fizzy drinks are well tolerated. Ginger root can be grated, then boiled to make tea. Nausea and vomiting triggers vary with different patients, so paying attention to what triggers episodes can help patients avoid the wrong foods.

Several oral medications are also used to treat hyperemesis gravidarum:

    • Metoclopramide is taken in a dosage of 10 mg every 8 hours for 24 hours. It works by speeding up stomach emptying and movements of the small intestine.

    • Promethazine is taken in a dose of 25 mg every 8 hours for 24 hours. It works by blocking spasms of stomach muscles.

    • Diphenhydramine is taken in a dosage of 12.5 to 25 mg every 4 to 6 hours.

When uncontrolled vomiting with dehydration becomes too severe, patients sometimes have to be admitted to the hospital. IV fluids with IV antiemetics (medications to cure nausea and vomiting), vitamins, and other nutrients are given. Fortunately the need for IV treatment and hospital care is rare.

Did you know? QuickMD can treat your mild case of hyperemesis gravidarum remotely by telemedicine, and prescribe oral medications online.

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