Which of the following is thought to be a cause of hyperemesis gravidarum
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During the first trimester of pregnancy, many women have the bouts of nausea and vomiting known as morning sickness. Show
Despite its name, morning sickness can happen day or night. It usually starts around the 6th week of pregnancy, is at its worst around week 9, and stops by weeks 16 to 18. Although unpleasant, morning sickness is considered a normal part of a healthy pregnancy. What’s Severe Morning Sickness?Severe morning sickness is when nausea and vomiting get so serious that a pregnant woman vomits several times a day, loses weight, and gets dehydrated or is at risk for dehydration. If this rare pregnancy-related condition isn’t treated, it can affect a woman's health and her baby's ability to thrive. The medical term for severe morning sickness is "hyperemesis gravidarum" (hi-per-EM-eh-sis grav-ih-DARE-um), which means "excessive vomiting during pregnancy." It usually follows a similar timeline to normal morning sickness. But it can go longer, sometimes lasting for the whole pregnancy. Often, the symptoms get less severe as the pregnancy continues. Most cases of hyperemesis gravidarum affect a woman's first pregnancy. But women who have it in one pregnancy are more likely to have it in future pregnancies. What Causes Severe Morning Sickness?The cause of severe morning sickness isn’t known. But it might be related to the hormone changes of pregnancy. A hormone called human chorionic gonadotropin, or HCG, might be to blame because severe morning sickness most often happens when HCG levels are at their highest in a pregnant woman's body. Severe morning sickness also might run in families. It’s more common in women whose close family members (such as mothers and sisters) have had it. Other things that can increase a woman's chances of having severe morning sickness include:
What Problems Can Happen?The nausea and vomiting that happen in severe morning sickness are so extreme that they can harm the mother and the baby. Not being able to keep down food makes it hard for the mom to meet her nutritional needs. So she might lose weight. And a loss of fluids, combined with the loss of stomach acid from vomiting, can cause dehydration and electrolyte imbalances. If severe morning sickness isn’t treated, it can cause many problems, including organ failure and the early birth of her baby. When Should I Call the Doctor?Call the doctor right away if you’re pregnant and have any of these symptoms:
How Is Severe Morning Sickness Treated?Treatments used for morning sickness, such as eating dry crackers in the morning or a bland diet, may be recommended for women with extreme morning sickness. But these might not help with severe symptoms. Medical treatment can include:
Some women might get medicine to stop the vomiting, either by mouth or through an IV. The doctor might recommend eating foods with ginger or taking vitamin B6 supplements to help ease nausea. It can also help to:
If a woman feels anxious or depressed about her condition, talking to a therapist or counselor might help her cope with her feelings. What Else Should I Know?With treatment, women with severe morning sickness can feel better and get the nourishment they need so they and their babies thrive. And lifestyle changes can help ease nausea and vomiting and make the pregnancy more enjoyable. With time, symptoms usually do improve. And, of course, they stop by the time a woman's next journey starts: parenthood. A few pregnant women have a severe kind of nausea and vomiting called hyperemesis gravidarum. With this condition, nausea and vomiting may be all day long. These women often lose weight, and get dehydrated. They may also have changes in the body's chemical processes.Placenta and appetite genes GDF15 and IGFBP7 are associated with hyperemesis gravidarum. Nat Commun. 2018 Mar 21;9(1):1178. doi: 10.1038/s41467-018-03258-0. Cohen R, Shlomo M, Dil DN, Dinavitser N, Berkovitch M, Koren G. Intestinal obstruction in pregnancy by ondansetron. Reprod Toxicol. 2014 Dec;50:152-3. Oliveira LG1, Capp SM, You WB, Riffenburgh RH, Carstairs SD. Ondansetron compared with doxylamine and pyridoxine for treatment of nausea in pregnancy: a randomized controlled trial. Obstet Gynecol. 2014 Oct;124(4):735-42. Fejzo M, Magtira A, Schoenberg FP, Macgibbon K, Mullin P, Romero R, Tabsh K.Antihistamines and other prognostic factors for adverse outcome in hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 2013; 170: 71–76. Pasternak B1, Svanström H, Hviid A. Ondansetron in pregnancy and risk of adverse fetal outcomes. N Engl J Med. 2013 Feb 28;368(9):814-23. Mullin PM, Ching C, Schoenberg F, MacGibbon K, Romero R, Goodwin TM, Fejzo MS: Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum. J Matern Fetal Neonatal Med. 2012; Jun;25(6):632-6. Mullin P, Bray A, Schoenberg-Paik F, MacGibbon K, Romero R, Goodwin TM, Fejzo MS: Prenatal Exposure to Hyperemesis Gravidarum Linked to Increased Risk of Psychological and Behavioral Disorders in Adulthood. J Dev Origins of Disease. 2011; 2:200-204. Veenendaal MV, van Abeelen AF, et al. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG 2011;118(11):1302-1313. Zhang Y., Cantor R., MacGibbon K, Romero R, Goodwin TM, Mullin P, Schoenberg Fejzo M. Familil Aggregation of Hyperemesis Gravidarum. AJOG 2011 Mar;204(3):230.e1-7. Vikanes A, Skjaerven R, Grjibovski AM, Gunnes N, Vangen S, Magnus P. Recurrence of hyperemesis gravidarum across generations: population based cohort study. BMJ. 2010 Apr 29;340:c2050. Fejzo MS, Poursharif B, Korst L, Munch S, MacGibbon KW, Romero R, Goodwin TM Symptoms and pregnancy outcomes associated with extreme weight loss among women with hyperemesis gravidarum, J of Womens Health. 2009 Dec;18(12):1981-7. Fejzo MS, Ingles SA, Wilson M, Wang W, Mac Gibbon K, Romero R, et al.. High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals. Eu J Obstet Gynecol 2008; 141:13-17. Goodwin TM, Poursharif B, Korst LM, MacGibbon K, Fejzo MS: Secular trends in the treatment of hyperemesis gravidarum. Am J Perinatol, 2008;25(3):141-7. Poursharif B, Korst L, MacGibbon KW, Fejzo MS, Romero R, Goodwin TM. Elective pregnancy termination in a large cohort of women with hyperemesis gravidarum. Contraception.2007;76(6):451-5. Seng JS, Schrot JA, van De Ven C, Liberzon I. Service use data analysis of pre-pregnancy psychiatric and somatic diagnoses in women with hyperemesis gravidarum. J Psychosom Obstet Gynaecol. 2007 Dec;28(4):209-17. What are the causes of hyperemesis gravidarum?What causes hyperemesis gravidarum? The condition might be caused by rapidly rising serum levels of hormones such as HCG (human chorionic gonadotropin) and estrogen.
Which hormone causes hyperemesis gravidarum?Affected individuals can progress from mild or moderate nausea and vomiting to hyperemesis gravidarum. While the cause of HG is likely multifactorial, currently, the most evidence exists for the placenta and appetite hormone GDF15 as playing an important role in the etiology of HG.
Which of the following is part of the definition of hyperemesis gravidarum?The most commonly accepted definition of hyperemesis gravidarum is a severe form of nausea and vomiting with weight loss greater than 5% of prepregnancy body weight, dehydration, acidosis from starvation, alkalosis from loss of hydrochloric acid, hypokalemia, ketosis, acetonuria, and ptyalism (excessive salivation) [4] ...
What is the most common complication of hyperemesis gravidarum?Complications of Hyperemesis Gravidarum
The main risks to women with hyperemesis gravidarum are dehydration, electrolyte imbalances, and weight loss. Women with prolonged hyperemesis gravidarum are at greater risk for preterm labor and preeclampsia, according to the HER Foundation.
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