Nausea and vomiting are common and often harmless early pregnancy symptoms that happen due to increases in human chorionic gonadotropin (hCG) and estrogen. These hormones can change a woman’s sense of smell and relax the digestive muscles; hence the symptoms.

However, there is a severe form of nausea and vomiting in early pregnancy, and it goes far beyond the common morning sickness many pregnant women experience. This condition is known as Hyperemesis gravidarum (HG); when nausea becomes extreme and vomiting occurs more than 3 times a day, it may indicate HG.

Typically starting around 4 to 6 weeks (peaking between 8 and 12 weeks) of gestation, HG affects around 0.3 to 3% of pregnancies and is one of the most common reasons for early pregnancy hospitalization. Thankfully, there are many safe treatments available in Singapore and your respective countries; that’s why you need to consult your doctor. 

What Does an HG Pregnancy Feel Like?

HG pregnancy makes you feel like you have overwhelming symptoms, such as:

1. Severe, consistent nausea and vomiting (much worse than normal pregnancy morning sickness).
2. Vomiting generally happens multiple times (more than three times) a day. This makes it hard to keep food or liquids down.
3. Experiencing tiredness and weakness because of constant nausea and dehydration.
4. You may lose more than 5% of your pre-pregnancy body weight.
5. These HG symptoms often start early, around 4 to 6 weeks into pregnancy.
6. The symptoms can last for weeks, months, or even the entire pregnancy.
7. There can be more saliva production and frequent spitting.
8. Dehydration signs include dark yellow urine, dizziness, and lightheadedness.
9. You may feel like you have extreme sensitivity to smells, lights, and motion.
10. There can be emotional impacts such as feelings of isolation, frustration, and sometimes depression, because the pregnancy feels very unpleasant.
    
    Also Read: What Is a Cryptic Pregnancy? Causes, Signs & Risk

Other Less Common Symptoms Include

1. Low blood pressure
2. Confusion
3. Jaundice due to liver damage
4. Wernicke-Korsakoff syndrome (a type of memory disorder due to a lack of thiamin (vitamin B1))
5. Rapid heart rate
6. Dry skin

Note: HG symptoms do not generally improve by mid-pregnancy. Hence, it may require medical treatment, including hospitalization for IV fluids. Consult your doctor in a timely manner for effective treatment and a safe pregnancy.

Also Read: Pregnancy, Maternity & Baby Care Tips

What are the Causes of HG Pregnancy

The exact cause behind HG pregnancy is still unknown, but some of the factors that can increase its risk are:

• Changes in Hormonal Levels

Pregnancy comes with increased levels of hormones like human chorionic gonadotropin (hCG) and other hormones like estrogen and progesterone. Higher levels of these hormones affect the stomach and can trigger severe nausea and vomiting.

• Growth and Differentiation Factor 15 (GDF15)

The feto-placental unit produces GDF15 early in pregnancy and is now considered a key cause. Recent studies indicate that it can trigger extreme nausea and vomiting by influencing the taste and vomiting center of the brain.

• Hereditary Predisposition

Women with a family history of HG are more likely to experience it themselves. Specific gene variants related to hormones and appetite regulation (such as GDF15, IGFBP7, and PGR genes) make some women more likely to have HG pregnancies.

• Gastrointestinal Modification

Pregnancy hormones slow down the process of digestion. This can decrease muscle tone in the stomach and food pipe, leading to acid reflux, nausea, and vomiting; these changes worsen HG symptoms.

• Changes in Thyroid Hormone 

Some women with HG have temporary overactive thyroid (known as gestational transient thyrotoxicosis (GTT)); this is linked to the hormone human chorionic gonadotropin (hCG). There can be a worsening of symptoms due to hormone overlap, especially with hCG.

• Other Factors

Larger placental mass (like in the case of twins) and possible environmental or psychosocial influences might contribute. However, these factors are less understood and need further clarification.

HG Pregnancy Risks

If left untreated, it can lead to the following condition:

• Maternal Risks

 Dehydration

• Electrolyte imbalances
• Nutritional deficiencies
• Psychological distress

• Fetal Risks 

• Preterm birth
• Low birth weight

When to See Your Doctor in Singapore

Do not ignore or wait for the symptoms to worsen; consult your doctor if you have:

1. Severe vomiting, and that too more than 3 times a day.
2. Can’t keep food and liquids down for more than 12 hours.
3. Lost over 5% of your pre-pregnancy weight.
4. Signs of dehydration, such as dark urine, dizziness, or fainting.
5. Presence of blood in the vomit.
6. Extreme stomach pain.
7. Feeling extreme weakness.
8. Persistent confusion.
9. Having a fast heartbeat.

Your doctor in Singapore may use tools such as PUQE-24 score. 

These scores range from

• Mild (4–6), 
• Moderate (7–12)
• Severe (13+)

This helps the healthcare professional to decide the severity and customize the treatment for HG.

What Safe HG Treatments Can My Doctor Recommend to Me?

After proper diagnosis, the treatment options for hg pregnancy in Singapore are:

• Lifestyle Management (For Mild to Moderate Cases)

• Dietary changes
• More fluid intake
• Prescribed ginger capsules, teas, or candies
• Acupressure
• Prenatal vitamin

• 
  Prescribed Medicines

If lifestyle changes are inadequate, then your doctor may recommend:

• First-line Drug Therapy: a combination of vitamin B6 and doxylamine
• Second-line Medications: Antihistamines and dopamine antagonists
• Third-line Medications (for severe cases): Stronger medications such as ondansetron or corticosteroids

   

  Hospital Treatment (For Severe Nausea Treatment)

Your doctor can recommend:

• Intravenous (IV) fluids
• IV anti-nausea medications
• Thiamine supplementation and tube feeding
• Total parenteral nutrition (TPN)

Note: These treatments discussed above are for educational purposes and are not intended to replace medical advice. Every woman is different; hence, treatment will be decided by the doctor as per your condition.

Conclusion

There are no proven ways to prevent hyperemesis gravidarum (HG). However, timely diagnosis and proper treatment are needed. This helps most women manage symptoms effectively and reduce risks to mother and baby. Remember that early medical intervention helps improve outcomes and ensure a safer pregnancy and delivery experience.

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