The first sign that you notice while pregnant is nausea and vomiting. Some women don’t experience it and some experience it extremely. This extreme form of vomiting leading to severe dehydration during pregnancy is termed to be ‘’Hyperemesis Gravidarum’’. Let’s split these words for easier understanding. ‘’Hyper’’ means ‘’High’’, ‘’Emesis’’ means ‘’Vomiting’’ and ‘’Gravidarum’’ means ‘’Pregnancy’’. So, How extreme is it? Is it different from your normal vomiting? Will it affect your pregnancy or baby in any way? When to seek medical help and how is it treated? To know all these read below

What is hyperemesis gravidarum? 
         Hyperemesis gravidarum is characterized by dehydration, weight loss, vomiting, nausea, and sometimes even fainting. It is a type of pregnancy complication and categorized under high risk pregnancy. If it is treated right from the beginning it gets better after 5 months of pregnancy, if left untreated it lasts throughout the entire pregnancy.

How to know whether you have normal vomiting or hyperemesis gravidarum?
         Normal morning sickness and vomiting disappear after the first trimester while hyperemesis gravidarum lasts throughout the entire pregnancy. Vomiting doesn’t cause dehydration while hyperemesis gravidarum does. With vomiting maximum, you will lose around 1-1.5 kgs while in hyperemesis gravidarum you will lose 2.5-4 kgs.

What is the cause behind this?
         Vomiting during pregnancy is caused due to the increase in the beta HCG hormone. For some women, this hormone suddenly spikes up in excessive amounts leading to this condition. There is no obvious cause on why it’s happening, but various theories have been proposed by researchers. Few say that the hormone GDF15 which is responsible for appetite, body weight regulation and food intake is the cause behind this. Few studies show that Vitamin b deficiency, Hyperthyroidism, H.pylori (Helicobacter) infection, and even psychological factors could cause this.

Who is at the risk of acquiring this?
         Women who fall under the following criteria are at a high risk of having hyperemesis gravidarum:
1. Multiple pregnancies
2. Overweight
3. Primigravida (Being pregnant for the first time)
4. Family history of hyperemesis gravidarum
5. History of having eating disorders
6. Trophoblastic disease (A rare tumor that grows inside the uterus)

When to seek medical help and why?
          When your vomiting is so severe and occurs after every meal or fluid you drink, do rush to the hospital. If your vomiting continues even after three months of pregnancy and is severe do let your healthcare provider know about it. Hyperemesis gravidarum can mimic other medical conditions or indicate an underlying disease, hence diagnosis is necessary. Few conditions that have the same symptoms as hyperemesis gravidarum includes:
1. Urinary tract infection
2. Meningitis (infection of the brain)
3. Digestive system disorders such as appendicitis, stones in the gallbladder or pancreas, and ulcers
4. Thyrotoxicosis (Excessive thyroid hormone in the body) 

          How will you identify whether you have hyperemesis gravidarum or any of these conditions? It’s simple. If you just experience severe vomiting accompanied by no other symptoms it is hyperemesis gravidarum. If it's accompanied by fever, stomach ache, seizures, muscle weakness, or unexplained pain then other conditions should be considered.

In what way does it affect your pregnancy or your baby?
         Hyperemesis gravidarum results in an increased risk of low birth weight, preterm birth, lack of baby’s growth in accordance to the gestational age and also preeclampsia (abnormal increase in blood pressure). It results in weakness, nausea and vomiting, fatigue, and severe weight loss therefore it becomes traumatizing for the mother physically as well as mentally. Showering or even lifting your hand becomes difficult. The woman feels like fainting even when she simply gets up. Women who had hyperemesis gravidarum during pregnancy are more likely to experience postpartum depression. Researchers also found that women become sensitive to certain smells and tastes and experience nausea even after a year post- delivery. 

Some facts about hyperemesis gravidarum
● Acupuncture doesn’t help with hyperemesis gravidarum
● About 2 percent of women with hyperemesis gravidarum choose to have an abortion
● Women with a history of molar pregnancy have a 50 percent chance of developing
hyperemesis gravidarum in the next pregnancy
● Women with hyperemesis gravidarum will not have the risk of miscarriage in the first trimester since the beta HCG levels will be tremendously high (The higher the level of the beta HCG hormone, the more solid is the pregnancy)
● Hyperemesis gravidarum is more common in the Asian population
● According to a study, around 2,85,000 women end up in the emergency department every year due to hyperemesis gravidarum.

Tips to manage hyperemesis gravidarum:
1. Rest as much as possible. Resting and sleeping help in reducing the symptoms.
2. Avoid foodstuff that is aggravating your nausea and vomiting. Avoid spicy, sugary and fatty food, and take a protein-rich diet. Eat smaller meals 6 times a day than three larger meals. Stick to a balanced diet. Adding ginger to the diet helps.
3. Stay hydrated as much as possible. Prefer more liquid food than solids.
4. Take vitamin b rich foods such as eggs, milk, avocado, spinach, banana, legumes, nuts, broccoli, fish, and cheese.
5. Stress makes hyperemesis gravidarum worse. Do practice breathing exercises or relaxation techniques every day to reduce stress.
6. Hypnosis and counseling also help.
7. Aromatherapy - Using an oil diffuser with lemon, orange, or mint aroma helps.
8. Avoid excessive physical movements such as driving and flickering lights.

         The key to managing hyperemesis gravidarum is early diagnosis and treatment, avoiding simple stuff at home such as perfumes that increase your sense of vomiting, staying hydrated and resting well.