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TREATMENT OPTIONS

Mild cases of hyperemesis gravidarum can be managed with rest, hydration, antacids, and avoidance of triggers such as certain odors, heat, humidity, noise, or flickering lights. Eating frequent small meals every 1 to 2 hours that include high-protein snacks and avoiding spicy or fatty foods may help. You can also try homeopathic remedies such as consuming ginger ale/tea or wearing an acupressure band, which applies pressure on a certain part of your wrist to reduce nausea. More severe cases may require hospitalization and intravenous fluids to provide hydration, fix electrolyte imbalances, and replenish low vitamins and minerals. Restoring vitamin B1 levels is especially important to prevent a serious neurologic disease called Wernicke encephalopathy. You may be given medications such as vitamin B6 (pyridoxine), metoclopramide, antihistamines, or antireflux agents to treat severe nausea and vomiting. If you have persistent vomiting and weight loss that is uncontrolled by medications, you may be given nutrition through a feeding tube into
your stomach.

WHEN TO CONTACT YOUR OSTEOPATHIC FAMILY PHYSICIAN

It is important to understand the difference between morning sickness and hyperemesis gravidarum because severe cases of hyperemesis gravidarum can cause dehydration, electrolyte imbalances, malnutrition, or unintended weight loss that may require intravenous fluids and nutritional support at the hospital. Please see your osteopathic family physician or obstetrician/gynecologist if you have any of these concerning symptoms during your pregnancy. In case of emergency, please call 911 or go to your nearest emergency department.

SOURCES

  1. ACOG Practice Bulletin No. 189: Nausea and vomiting of pregnancy. Obstetrics and gynecology. Published January 2018. Accessed May 8, 2022. https://pubmed.ncbi.nlm.nih.gov/29266076/

  2. American Pregnancy Association. Hyperemesis gravidarum. Published December 9, 2021. Accessed May 8, 2022. https://americanpregnancy.org/healthy-pregnancy/ pregnancy-complications/hyperemesis-gravidarum /

  3. Cleveland Clinic. Hyperemesis gravidarum. Published December 2, 2020. Accessed May 8, 2022. https://my.clevelandclinic.org/health/diseases/12232-hyperemesis- gravidarum-severe-nausea--vomiting-during-pregnancy

  4. Smith J. Nausea and vomiting of pregnancy: clinical findings and evaluation. In: Post TW, ed. UpToDate; 2022. Accessed May 8, 2022. https://www.uptodate.com/ contents/nausea-and-vomiting-of-pregnancy-clinical-findings-and-evaluation?search=hyperemesis%20gravidarum&source=search_result&selectedTitle=2~137&usag e_type=default&display_rank=2

  5. Smith J. Nausea and vomiting of pregnancy: treatment and outcome. In: Post TW, ed. UpToDate; 2022. Accessed May 8, 2022. https://www.uptodate.com/contents/nausea- and-vomiting-of-pregnancy-treatment-and-outcome?search=hyperemesis%20gravidarum&source=search_result&selectedTitle=1~137&usage_type=default&display_rank=1

The associated image was used with permission from the Community Memorial Hospital Graduate Medical Education.