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

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

See also “Pregnancy and Baby” section for Coping with hyperemesis gravidarum or  click here.


Author: Dr Ng Soon Pheng

Dr. Ng Soon Pheng MD(USM), M.Med (O&G), Fellow Reprod Medicine (Singapore), AM (Mal) Dr. Ng Soon Pheng qualified from University Kebangsaan Malaysia (UKM), Malaysia. After obtaining his post graduate degree, Dr. Ng Soon Pheng continued his clinical fellowship training in the field of IVF in Singapore. He was also the recipient of Yayasan Sultan Iskandar (Johor) Scholarship for the fellowship stint. Dr. Ng Soon Pheng has more than 10 years of working experience in the field of Obstetrics and Gynaecology in the public and university hospital, with special interests in infertility. He was an Associate Professor with the Department of O&G in Universiti Kebangsaan Malaysia (UKM) specialising in infertility. Dr. Ng Soon Pheng is currently Consultant Obstetrician and Gynaecologist with special interests in infertility at Columbia Asia Hospital - Puchong.

One thought on “Hyperemesis gravidarum- Oh,Oh!! Nothing seems to stay in my tummy”

  1. 🙂 Dr Ng, totally agree with you about Hyperemesis gravidarum. Am glad mine started to subside from 12th wk onwards.

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