Hyperemesis gravidarum
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Hyperemesis gravidarum is very severe pregnancy sickness. There are a number of medicines that can be used safely to improve the symptoms of hyperemesis gravidarum.
What is hyperemesis gravidarum?
Up to three in every 100 pregnant women get a very severe type of pregnancy sickness called hyperemesis gravidarum. Affected women have very bad nausea (feeling sick) and/or vomiting (being sick). This means they cannot eat or drink normally and can’t carry out their daily activities. Constantly feeling and/or being sick and being unable to live a normal life can also cause problems with mental health.
What medicines are used for hyperemesis gravidarum?
Your doctor might offer you an antihistamine first. Antihistamines that can help with sickness include cyclizine, prochlorperazine, chlorpromazine, and promethazine. A drug called Xonvea® is also available, which combines an antihistamine (doxylamine) with vitamin B6.
If an antihistamine doesn’t help within two days, your doctor can talk to you about using other medicines. These include ondansetron, metoclopramide, and domperidone. Some women may need to use more than one medicine at the same time to feel better.
Benefits
What are the benefits of using a medicine to treat hyperemesis gravidarum?
Using an anti-sickness medicine in pregnancy can improve your symptoms. Some women will feel well enough to carry on with their normal daily activities.
Treatment of hyperemesis gravidarum can help to prevent dehydration (where you don’t have enough water in your body) caused by being sick and not drinking properly. Effective sickness treatment can help you avoid hospital treatment for dehydration.
Treating sickness and nausea can allow you to eat. This can help your unborn baby to grow and reduce the chance of them having a low birth weight.
Risks
Are there any risks of using a medicine to treat hyperemesis gravidarum?
Overall, these medicines are considered to be safe for your baby.
Although ondansetron has been linked to a small increase in the risk of cleft palate and some heart defects in babies who were exposed in the womb, it is clear that this is very rare. It is important to balance this small risk against the benefits to you, your unborn baby, and your wider family of your pregnancy sickness being well-treated. For more details, see the Bump leaflet on Ondansetron.
Alternatives
Are there any alternatives to using a medicine to treat hyperemesis gravidarum?
Not usually. Because hyperemesis gravidarum is so severe, it generally needs treatment with a medicine.
No treatment
What if I prefer not to use a medicine to treat hyperemesis gravidarum?
If you cannot eat or drink normally, you are vomiting up medicines that you need to take, and/or you cannot carry out your normal activities, there is no need to suffer. It is important to get the correct anti-sickness treatment to keep you as well as possible.
Will my baby need extra monitoring?
As part of their routine antenatal care, most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects. Using anti-sickness treatments does not mean that you need any extra monitoring during pregnancy.
If you have hyperemesis gravidarum that carries on after week 20, you might be offered extra scans in later pregnancy to keep an eye on your baby’s growth. Your health and wellbeing will also be regularly monitored.
Who can I talk to if I have questions?
If you have any questions relating to the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.
The charity Pregnancy Sickness Support provides resources, information and advice for women experiencing hyperemesis gravidarum.