Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with: -loss of greater than 5% of pre-pregnancy body weight (usually over 10%) -dehydration and production of ketones -nutritional deficiencies -metabolic imbalances -difficulty with daily activities Most affected women have numerous episodes of vomiting throughout the day with few if any symptom-free periods, especially during the first three to four months. This leads to significant and rapid weight loss, dehydration, electrolyte disturbances, and nutritional deficiencies often requiring hospitalization. Symptoms such as changes in taste or smell, nausea and vomiting usually begin around week 4-6 and peak between 9-13 weeks. Onset of symptoms may occur before the pregnancy is confirmed by an elevation in hCG level (positive pregnancy test). Typically, there is resolution or at least significant improvement somewhere around 14-20 weeks, however, some women (10-20% or more) continue to require significant care for their entire pregnancy. Most affected women have numerous episodes of vomiting throughout the day with few if any symptom-free periods, especially during the first three to four months. This leads to significant and rapid weight loss, dehydration, electrolyte disturbances, and nutritional deficiencies often requiring hospitalization.

Knowing how to help a woman with HG may be confusing. You have not likely experienced it before and don't really know what she is feeling, but obviously want to help since you are taking this course. Know that she is not making herself sick, nor can she control her vomiting/nausea. HG is a serious illness that has been largely misunderstood by health professionals because the cause of HG has not yet been identified, thus some wrongly assume it is psychological. HG typically resolves by mid-pregnancy; however, it may last until delivery. For most moms, HG is gone at delivery, but for some, it does not fully resolve for days or weeks. The first 3-4 months of an HG pregnancy are usually the worst for a woman. She will need the most help and support during this time. The first way you can help is to learn about HG. Pregnant women with HG as well as their families and friends need to be understanding and adaptable, especially in regard to diet. Food cravings can be bizarre, complex, irregular and often a woman's whole life becomes centered around food. Cravings often appear for only a short time - maybe just a few minutes and need to be fulfilled if at all possible. The primary goal is to increase nutrient and fluid intake by any means possible. It's important to create a network of support for all aspects of daily life to minimize stress and provide foods as tolerated. Stress (mental, physical or emotional) and malnutrition only worsen HG. Your support will greatly impact how well she copes with this illness.