Hyperemesis gravidarum - Oh,Oh!! Nothing seems to stay in my tummy

March 03, 2011



The joy of knowing that one is pregnant is often interrupted by feeling of bloatedness, poor appetite and nausea. Most women (50-90%) will have these symptoms during their early stage of pregnancy but gradually subside by the 14-16th weeks. Morning sickness, another name for this condition is coined due to the belief that these symptoms are commonly experience by pregnant mothers in the morning.

Hyperemesis gravidarum is associated with the rising pregnancy hormone (HCG, human chorionic gonadotrophin). Once the placenta is fully functional, the HCG hormone declines and hyperemesis improved. It does not affect the fetus but can be a challenging experience for most pregnant mothers. Besides the discomfort of nausea and bloated, medication is usually not necessary for most cases. Very rarely, severe hyperemesis is associated with liver (Wernicke’s encephalopathy) or kidneys (acute renal failure) complications. Looking at the bright side, hyperemesis indirectly indicates a healthy ongoing pregnancy. Only in a normal pregnancy, the HCG hormone will rise accordingly. On the contrary, women with missed abortion or failed pregnancy will not have a decline in the serum HCG level, which clinically manifest as regression of symptom.

I do not often prescribe anti-emetic drugs for my patients except if the hyperemesis is severe. I generally advise them to choose their food carefully, identify symptom triggers to avoid them, and take frequent but small snacks. There are also other alternative methods such as acupressure, acupuncture, taking ginger drinks and hypnosis but their effectiveness remains to be proven.

Embrace and welcome your pregnancy symptoms. They are challenging but mostly transient


Dr. Ng Soon Pheng
Consultant Obstetrician & Gynecologist
Columbia Asia Hospital- Puchong