If there is an extreme, persistent nausea and vomiting during pregnancy that is considered as hyperemesis gravidarum. Sometimes it may lead to dehydration. Nausea or vomiting during the first 3 months of pregnancy is almost common. It is called as "morning sickness ". This may extend sometimes more than 3 months. It is due to rapidly rising blood levels of a certain hormone released by the placenta during pregnancy. In case of pregnancy with twins or more the intensity would be more. Hyperemesis gravidarum can lead to fluid and electrolyte imbalances and nutritional deficiencies. Liver damage and jaundice may occur with severe hyperemesis gravidarum. Excessive weight loss and poor nutrition in the mother may affect fetal growth.
During the pregnancy the levels of human chorionic gonadotropin (HCG), which is released by the placenta, would be rapidly rising. It develops the symptoms of hyperemesis gravidarum.
The symptoms of hyperemesis gravidarum may vary from woman to woman. General symptoms are constant nausea, especially after the first trimester, vomiting in general, which may aggravate after eating or drinking, weight loss and dehydration.
Exams and tests
There may be low blood pressure and increased pulse rate. Laboratory tests like hematocrit and urine ketones may be done to check dehydration. CAM physician advise other tests to monitor the functions of liver and gastrointestinal tract. Ultrasound would be helpful to find out whether twins, multiple pregnancy or hydatidiform mole.
Taking the food in small quantity and frequently would be helpful to manage the condition. Dry foods such as crackers may help relieve uncomplicated nausea. Fluid intake should be taken more to avoid dehydration. Taking Vitamin B6 containing food may be helpful to decrease the nausea in early pregnancy. Medication to prevent nausea is usually to be avoided. IV fluids can be helpful in severe cases.
Usually it will start decline during the second trimester. Rarely the condition ends up with complications like dehydration, liver damage, jaundice, weight loss, malnutrition of the fetus, etc.
CAM therapies for hyperemesis gravidarum
Acupuncture and acupressure are helpful to manage hyperemesis gravidarum. Acupressure bracelets are recommended by may practitioners. It applies the pressure to the indicated points, especially p6, persistently. This point can be stimulated by the patients themselves to reduce nausea. Mild nausea, even morning sickness, may improve by using the middle and index fingers to press firmly down on the groove between the two large tendons on the inside of the wrist that start at the base of the palm. Special wristbands to help relieve nausea are sold over the counter at many stores. When the band is worn around the wrist, it presses upon the same or similar pressure points. The bands are not expensive and are reported to work for some people.
Many useful ayurvedic products are helpful. Dashamula Arishta is helpful. It can be taken after meales. Apart from this Mayurapicha Bhasma, Shanka Bhasma, Swarna Makshik Bhasma, Vilavadi Kashaya are also useful. Usually Drakshadhik Vata Choorna, Talisadi Choorna are also recommended. Biladi Lehya and Kasturyadi Lehya are given in the category of Lehya.
Ginger is effective in hyperemesis gravidarum. The volatile oils presents in ginger aids digestion, soothes the irritated linings, and tones muscles of digestive tract. It also stimulates liver to produce bile which helps in fat digestion. It can be taken about three to four hours before travel, in case of motion sickness. Peppermint tea is also a better choice in hyperemesis gravidarum.
Dehydration is to be taken care mainly at home. Electrolyte solutions are to be taken regularly if necessary. Other clear liquids such as water, ginger ale, or fruit juices also work unless the vomiting is severe. Stretching the stomach is to be avoided, because it can make nausea and vomiting worse. Semi solid food is to be preferred.
Following remedies are usually recommended by homeopaths.
Ipecacuanha: Constant nausea with profuse saliva in the mouth. Vomiting of white glairy mucus in large quantities, without relief and sleepy afterwards; worse by stooping. Stomach feels as if hanging down. Nausea not better by vomiting.
Nux vomica: Nausea and vomiting every morning with depression of spirit. Constant nausea. The woman feels as if, she vomits; then she feels much better. Nausea and vomiting after eating. Pain in the stomach two or three hours after eating; with loss of consciousness. Feeling of tightness in the abdomen after a meal; must loosen the clothing. Sour taste in the mouth. Tongue coated thick white. Angry, irritable and impatient patient. Headache associated with vomiting; sensation as if head was immensely become large. Violent vomiting, bilious and sour.
Symphoricarpus: Persistent vomiting of pregnancy. Morning sickness. Nausea, worse from any motion. Aversion to all food. Deathly nausea. Continuous retching and vomiting. Better by lying on back and worse by motion. Constipated.
Lactic acid: During pregnancy; morning sickness, salivation, nausea and vomiting, water brash better by breakfast. Vomiting of pregnancy with thirst and voracious hunger. Nausea, on waking better by eating. During pregnancy; morning sickness, salivation, nausea and vomiting.
Sepia: Nausea at the sight or smell of food. Great longing for acids or pickles. Inclination to vomit in the morning, when raising her mouth out. Constipation during pregnancy. Nausea in the morning before eating. Nausea worse lying on side. Eructation like spoiled egg; aversion to meat. Sensation of a lump in the stomach. Heaviness or sensation of a load in the abdomen, especially during motion.
Tabacum: Nausea during pregnancy, with much spiting. Deathly nausea, giddiness with violent vomiting. Uncovering of abdomen relieves the nausea and vomiting. Sensation as if stomach were hanging down relaxed with nausea. Sudden urging with nausea, vomiting and cold sweat. Vomiting from least movement. Vomiting of fecal matter. Incessant nausea, worse smell of tobacco smoke. Vertigo, increasing to loss of consciousness; relived in open air and by vomiting.
Asarum europaeum: Nausea in attacks or constant aggravated after eating. Tongue clean. Bread taste bitter. Nausea with aching in forehead, with watery saliva in mouth. Vomiting with great anxiety and violent retching.
Nux moschata: Nausea and vomiting with pain in abdomen, accompanied by drowsiness and sleepiness. Abdomen enormously distended after every meal. Oversensitive to light, voice, odor and touch
Kreosotum: Vomiting of pregnancy, usually before the breakfast; sweetish vomiting with ptyalism. Nausea, vomiting of food several hours after eating of sweetish water in the morning in pregnancy of undigested food.
Pulsatilla: Morning sickness with vomiting of mucus. Loathing nausea and retching after greasy food. Nothing tastes good to her. Great dryness in the mouth in the morning without thirst. Sensation as if the food were lodged undigested above the stomach. Craves fresh, cool air. Chilly yet aversion to heat. Pressure in the abdomen and back, as from stone. All gone sensation in the stomach; colicky pain; must change her position to relieve pain.
Cocculus indicus: Nausea while riding in a boat, cars, carriage, etc. Nausea, worse on becoming or taking cold. Aversion for food. Vertigo on rising up in bed. The thought of food or its smell will nauseate the woman. Aversion to acids, desire for cold drinks. Vomiting with profuse flow of saliva with headache, pain in bowels, on taking cold. Vomiting of sour, bitter and bad odor. Sensation of inner organ emptiness, constriction. Paroxysms of vertigo with nausea. Thirst without desire to drink.
Colchicum: Nausea and inclination to vomit, caused by swallowing saliva. Nausea from the odor of fat, meat or eggs. Loss of appetite. Brown coated tongue. Nausea and loathing at the thought of food. Extreme aversion to food. Sensitiveness of whole body
Antimonium crudum: Patient with excessive irritability and fretfulness. Vomiting worse by eating or drinking without nausea or relief. Vomiting with white coated tongue. Vomiting as soon as she eats or drinks. Nausea, vomiting and diarrhoea during the pregnancy. Tongue coated, like white ash. Longing for the pickles and acids. Aggravation after bathing; taking cold water. Digestive troubles, from overloading stomach. Aversion to be looked at; and to be touched.
Anacardium orientale: Vomiting of ingesta. Nausea during pregnancy; ameliorated by eating but return and continue until the patient eats again. Nausea, belching. Feels better from vomiting. Empty feeling in stomach.
Phosphorus: During pregnancy; unable to drink water; sight of it causes vomiting; must close her eyes while bathing. Longs for cold food and drink; juicy, refreshing things; ice cream ameliorates gastric pains. Vomiting as soon as water becomes warm in stomach it is thrown up. Regurgitation of ingesta in mouthfuls. Nausea from placing hands in warm water.
Arsenic album: Nausea, retching and vomiting after eating and drinking. Ice cold water distresses the stomach and is vomited immediately. Great thirst for cold water; drinks often, but little at a time; eats once but in huge quantity. Can not bear the sight and smell of food.