What causes severe vomiting during pregnancy?

Severe vomiting during pregnancy is closely related to the increase of human chorionic gonadotropin in the body. Endocrine disorders, mental stress, anxiety, etc. during pregnancy can cause vomiting. It is normal to experience vomiting in early pregnancy, and you can choose to adjust your food to relieve it. Many pregnant women suffer from severe vomiting, which can affect their physical health and the development of the fetus. In severe cases, they may even suffer from kidney failure and endanger the life of the pregnant woman.

Causes

The causes of early pregnancy reactions may be related to increased human chorionic gonadotropin (HCG) in the body, gastrointestinal dysfunction, decreased gastric acid secretion and prolonged gastric emptying time. 0.3% to 1% of pregnant women will experience hyperemesis gravidarum, which is more common in young primiparas and is generally believed to be related to a significant increase in HCG. The basis for this is that the time when early pregnancy reactions appear and disappear coincides with the time when the pregnant woman's blood HCG level rises and falls. The blood HCG levels of pregnant women with hydatidiform mole and multiple pregnancies are significantly increased, and the incidence of severe vomiting is also high, indicating that hyperemesis gravidarum may be related to elevated HCG levels. However, the degree of clinical manifestations is sometimes not necessarily proportional to the blood HCG level. Pregnant women who are overly nervous, anxious, worried, or have a poor living environment and economic conditions are prone to hyperemesis gravidarum, suggesting that this disease may be related to mental and social factors. Recent studies have found that hyperemesis gravidarum may also be related to infection with Helicobacter pylori.

Clinical manifestations

Hyperemesis gravidarum occurs between early pregnancy and 16 weeks of gestation and is more common in young primigravidas. Generally, early pregnancy reactions appear about 40 days after menstruation has ceased and gradually worsen until frequent vomiting and inability to eat. The vomit contains bile or coffee-like substance. Severe vomiting can cause dehydration and electrolyte imbalance, and mobilize body fat, causing the intermediate product acetone to accumulate, causing metabolic acidosis. Patients experience significant weight loss, pale complexion, dry skin, weak pulse, decreased urine volume, and in severe cases, a drop in blood pressure, causing prerenal acute renal failure. Hyperemesis gravidarum can lead to two serious vitamin deficiencies.

treat

Patients with hyperemesis gravidarum should be hospitalized and fast for 2 to 3 days. The amount of water loss and electrolyte imbalance should be determined based on laboratory test results, and water and electrolytes should be supplemented as appropriate. Glucose solution and Ringer's solution are dripped intravenously every day, with the addition of vitamin B6, vitamin C, potassium chloride, etc. Maintain daily urine volume above 1000 ml. And give vitamin B1 intramuscular injection. People with malnutrition can be given fat emulsion and amino acids intravenously. Generally, the condition will improve after 2 to 3 days of the above treatment. Pregnant women can try a small amount of liquid food after vomiting stops and symptoms are relieved. If there are no adverse reactions, they can gradually increase the amount of food they eat and adjust the amount of fluid replacement.

Most pregnant women with hyperemesis gravidarum improve after treatment and can continue their pregnancy. If conventional treatment is ineffective and persistent jaundice, persistent proteinuria, elevated body temperature above 38°C, tachycardia (≥120 beats/min), and Wernicke's syndrome occur, which endanger the life of the pregnant woman, termination of pregnancy should be considered.