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While morning sickness can occur in up to 70 percent of all pregnancies, it is usually more troublesome than serious. The more severe and disturbing condition, hyperemesis gravidarum, may complicate up to 0.3 percent (3 out of 1000) pregnancies, causing physiological changes that may effect the mother and fetus. Maternal weight loss, dehydration, electrolyte imbalances, acid-base disturbances leading to renal and hepatic injury have all been reported in extreme cases. Persistent vomiting can lead to Mallory-Weiss tears and nutritional deficiencies may lead to Wernicke's encephalopathy.
Prematurity, low birth weight and a slight increase of central nervous system and integumentary malformations have been reported in fetuses of mothers affected with hyperemesis gravidarum. An increase risk of testicular cancer in male patients of mothers with hyperemesis gravidarum during their pregnancy has also been reported in the urology literature.
Hyperemesis gravidarum should be considered when all other causes of persistent nausea and vomiting have been ruled out. Pyelonephritis, pancreatitis, cholecystitis, hepatitis, appendicitis, gastroenteritis, peptic ulcer disease, thyrotoxicosis, and hyperthyroidism can present in similar fashions, with intractable nausea and vomiting, and are treatable conditions. Late presenters need also to be ruled out for HELLP syndrome and other causes of hepatic and central nervous system dysfunction.
The etiology of hyperemesis gravidarum is not well understood. Hormonal causes related to human chorionic gonadotropin, estradiol, progesterone, adrenal hormones and pituitary hormones have been proposed, but currently there is no conclusive evidence implicating any specific substance. Psychological and social factors influence this disease, such as in unwanted pregnancies, although this syndrome is not limited to unwanted pregnancies. Young, unwed mothers whom are felt to have "sinned" and therefore harassed by their parents, are common sufferers of this syndrome. Remarkable improvement with hospitalization is often noted in such cases, with rapid relapses once released to the home environment. Hysterical and immature personalities can predispose one to this condition.
The diagnostic work-up must always start with confirmation of a viable, intrauterine pregnancy. Gestational trophoblastic neoplasia can present with hyperemesis gravidarum in up to 30 percent of cases. Electrolytes, liver function tests, thyroid function tests, creatinine, blood urea nitrogen, urinalysis and a complete blood count are some of the studies that need consideration in the work-up.
Once the diagnosis is made, treatment consists of mainly supportive care. Intravenous fluid, up to 5 to 6 liters per day using the appropriate amounts of sodium, potassium, chloride, lactate or bicarbonate, glucose and water, are primarily used in correcting the hypovolemia, electrolyte and acid-base imbalances, and ketosis. Until vomiting is controlled, these women should be maintained as NPO (nothing per oral). A low dose, continuous infusion of an antiemetic, such as promethazine, can have beneficial effects. Vitamins, including thiamine, can be added to supplement the intravenous fluids. Patients should be maintained NPO for at least 48 hours after all symptoms and vomiting have ceased, to prevent rapid regress. Initiate PO (per oral) intake with neutral fluids and a small, bland, dry, carbohydrate diet, in frequent intervals. Avoid noxious stimuli such as unpleasant odors. Reassurance and emotional support is important at this time, and psychological counseling can be initiated once symptoms have abated.
Patients with intractable, prolonged vomiting may be treated with nasogastric enteral feedings, peripheral parenteral nutrition, or total parenteral nutrition. Rarely is interruption of pregnancy necessary.
Oral medications have long been the main stay of out-patient treatment. Until forced off the market Bendectin [pyridoxine-vitamin B-6 (10 mg) and doxylamine succinate (10 mg)], a category B medication, was efficacious and safe for both mother and fetus (This was removed from the market in 1984 and listed as a known or suspected teratogenic chemical). This formula can be reproduced over-the-counter using Unisom Nighttime Sleep Aid (25 mg) (not Maximum Strength Unisom Sleepgels, which contains diphenhydraminehydrochloride) one half tablet and Vitamin B-6 (25 mg) one half tablet, each in the morning and afternoon, and one tablet each at bedtime, as needed. Useful category C medications are prochlorperazine, promethazine, trimethobenzamide, and droperidol. Although because of their category designation, informed consent should be obtained on all patients treated with the above medications. (Anytime your health care provider asks for an informed consent before giving you a medication, this should be a red-flag for consumers about the product.)
Note: Italics added by MoonDragon.org research staff.
- Briggs G, Freeman R, Yaffe S: Drugs in Pregnancy and Lactation, 2nd edition. Baltimore, Williams and Wilkins, 1986
- Creasy R, Resnik R: Maternal-Fetal Medicine: Principles and Practice, 2ndedition. Philadelphia, W.B. Saunders, 1989
- Gabbe S, Neibyl J, Simpson J; Obstetrics: Normal and Problem Pregnancies, 2ndedition, Churchill Livingstone, 1991
- Cunningham F, MacDonald P, Gant N: Williams Obstetrics, 18th edition. Appleton and Lange, 1989
- Greenspoon J, Rosen D, Ault M: Use Of The Peripherally Inserted Central Catheter For Parenteral Nutrition During Pregnancy. Obstetrics and Gynecology 1993;81:831-4
- Hsu J, Clark-Glena R, Nelson D, Kim C: Nasogastric Enteral Feeding In The Management Of Hyperemesis Gravidarum. Obstetrics and Gynecology 1996;88:343-346
RELATED LINKS
MoonDragon's Pregnancy Information: Hyperemesis Gravidarum - Conventional Medical
MORNING SICKNESS SUPPLEMENTS & PRODUCTS
Supplements and products for morning sickness, the feeling of nausea and vomiting that occurs in the first few months of pregnancy.
Alfalfa Leaves, Nature's Way, 405 mg, 100 Caps
Nature's Way Alfalfa Leaves are organically grown by Trout Lake Farm, Washington, and Certified Organically Processed in accordance with Oregon Tilth standards and the California Organic Foods Act of 1990.Arsen Alb (Arsenicum Album) Homeopathic Clikpak, 30C, 84 Pellets
Homeopathic Nelsons Arsen alb in the new clikpak is easy to carry and dispense for upset stomach, diarrhea and vomiting and therefore much better suited to a busy lifestyle.Female Estrogen with Progestrone Tincture, 100% Organic, 2 fl. oz.
Female Estrogen With Progestrone formula is used mainly to promote hormonal balance. It does not contain hormones, however.Ginger Peach Longevity Tea, Republic of Tea, Regular, 50 Tea Bags
Ginger Peach Longevity Tea is one of the best selling teas with the sweet lushness of a fancy peach with spicy ginger. Voted "Outstanding Beverage" by the National Association of the Specialty Food Trade.Ginger Root, Nature's Way, 550 mg, 180 Caps
Ginger root is especially useful for bowel disorders including indigestion, morning sickness, motion sickness and nausea.Ginger Root Powder (Zingiber Officinale), 4 oz. Bulk
Ginger is used medically to help expel gas from the intestines and treat nausea from morning sickness, upset stomach, seasickness, and motion sickness. It is also used to help reduce fevers and lessen the symptoms of colds. Ginger's ability to prevent vomiting has been verified by clinical trial, and it has been shown to stimulate the intestines and promote production of saliva, digestive juices, and bile. It also tends to boost the pumping action of the heart.Ginger Root Tincture, 100% Organic, 2 fl. oz.
Ginger Root helps to promote gastric secretions, thus aiding with food absorption and excellent for indigestion, flatulence, nausea (including travel sickness), and colic. Ginger root has also been recommended as a treatment for atherosclerosis, migraine headaches, rheumatoid arthritis, high cholesterol, burns, ulcers, depression, impotence, and liver toxicity.Ginger Tea, 20 Tea Bags
Caffeine Free Ginger Tea is used in Chinese medicine to remove toxins, warm the stomach, maintain good health, especially in changing weather conditions, and to prevent seasickness.Kelp Seaweed (Norwegian) Tincture, 100% Organic, 2 fl. oz.
Due to overwhelming research results, Kelp has become an effective treatment for hyperthyroidism.L-Methionine, 500 mg, Plus B-6, 10 mg, NOW Foods, 100 Caps
L-Methionine is an essential sulfur amino acid. The body cannot produce L-Methionine, which must be obtained from food or supplement sources.Motion Mate Formula With Ginger (Natural Motion Sickness Remedy), Nature's Way, 100 Caps
Motion Mate, a natural motion sickness remedy, formula is based on clinical studies that show ginger root is more effective against motion sickness than dimenhydrenate, but exhibits none of the negative side effects.Nausea / Morning & Motion Sickness Tincture, 100% Organic, 2 fl. oz.
The Nausea / Morning & Motion Sickness Tincture is for upset stomach, nausea, and morning sickness; helps to soothe and calm the stomach.Nausea Wellness Oil, Nature's Inventory, 2 fl. oz.
This Wellness Oil is designed to relieve general nausea as well as morning sickness, motion sickness.Peppermint Stomach Soother Tea, Yogi Tea, Caffeine Free, Certified Organic, 16 Tea Bags
Organic Peppermint Tea from Yogi Tea is the perfect way to lift your spirits and quiet your stomach; with a fresh flavor and aroma you will want to enjoy everyday.Prenatal Multi-Vitamin & Mineral, 100% Natural & Complete, Nature's Way, 180 Caps
Nature's Way Prenatal Vitamin with Folic Acid is a women's complete vitamin formulated to support the health of the mother and child. Nature's Way Woman's Prenatal Multivitamin and mineral supplement provides specially balanced prenatal vitamin and mineral potencies for pregnant women or postnatal lactating women.Red Raspberry Tincture, Red Raspberry Supplement, Liquid, 100% Organic, 2 fl. oz.
Stomach Upset Formula is used as an all natural herbal remedy for an upset stomach and acidosis, digestive problems, halitosis, morning sickness, and motion sickness.Vitamin B-6 (Pyridoxine), 100 mg, 100 Caps
Vitamin B-6 (Pyridoxine) is converted in the body to the main coenzyme responsible for amino acid and protein metabolism.Vitamin C 500 with Rosehips, Nature's Way, 100% Natural, 500 mg, 250 VCaps
Nature's Way Vitamin C with Rosehips offers a rich whole plant source of vitamin C which provides antioxidant protection useful in treating infections, bruising, colds & flu, sinusitis, sore throats, blood clots, atherosclerosis, high blood pressure, physical and mental stress, immune function, cholesterol levels, liver toxicity and assists in collagen formation.Vitamin C 1000 with Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Woman's Mother-To-Be Tea, Yogi Tea, Certified Organic, 16 Tea Bags
Organic Woman's Mother to Be from Yogi Tea is a simple and organic way to support your body changes during pregnancy.Herbal Remedies: Morning Sickness Information
Herbal Remedies: Morning Sickness Supplements & Products
ELECTROLYTE REPLACEMENT PRODUCTS
Electro C Powder, Vitamin C Supplement, Cherry Flavor, 1250 mg, 8 oz.
NutriBiotic Electro-C, a natural vitamin c supplement, delivers natural vitamin C and minerals in concentrations higher than can be found in food, while being hypo-allergenic.Electrolyte Drink Concentrate, Endure, Trace Minerals, 4 fl. oz.
Endure is a perfectly balanced pure electrolyte concentrate that contains important electrolytes such as potassium, sodium, magnesium, chloride, and sulfate. Many sports drinks contain only potassium and sodium. Endure not only contains these important electrolytes, but contains magnesium, an essential electrolyte that naturally relaxes muscles to prevent cramping - a nemesis to the performance athlete. Endure can be added to whatever you want, whenever you need it. Now you do not have to consume sports drinks that are full of sugar and carbs for hydration. Get your carbs at whatever rate works best for you and add in Endure for pure and effective hydration - the perfect combination to enhance your performance. Serving Size is 1/2 Teaspoon Added to any beverage and mix well.Electrolyte Stamina Power Pak, Concord Grape Flavor, Trace Minerals, 32 Ct Packs, 0.23 oz Each Pack
Electrolytes are needed to maintain proper fluid balance and to optimize your energy levels so you can function at your best. Electrolyte Stamina Power Pak is an easy-to-fix high performance energy drink with no caffeine, artificial stimulants or artificial ingredients. This formula contains 1200 mg of Vitamin C, an essential anti-oxidant for people who are active and on the go. It also contains all major electrolytes (potassium, magnesium, chloride and sodium), plus over 72 verified ionic minerals and trace minerals from ConcenTrace®, which accelerates assimilation and absorption of vitamins and nutrients.Electrolyte Stamina Power Pak, Cranberry Flavor, Trace Minerals, 32 Ct Packs, 0.23 oz Each Pack
Electrolytes are needed to maintain proper fluid balance and to optimize your energy levels so you can function at your best. Electrolyte Stamina Power Pak is an easy-to-fix high performance energy drink with no caffeine, artificial stimulants or artificial ingredients. This formula contains 1200 mg of Vitamin C, an essential anti-oxidant for people who are active and on the go. It also contains all major electrolytes (potassium, magnesium, chloride and sodium), plus over 72 verified ionic minerals and trace minerals from ConcenTrace®, which accelerates assimilation and absorption of vitamins and nutrients.Electrolyte Stamina Power Pak, Lime, Trace Minerals, 32 Ct Packs, 0.23 oz Each Pack
Electrolytes are needed to maintain proper fluid balance and to optimize your energy levels so you can function at your best. Electrolyte Stamina Power Pak is an easy-to-fix high performance energy drink with no caffeine, artificial stimulants or artificial ingredients. This formula contains 1200 mg of Vitamin C, an essential anti-oxidant for people who are active and on the go. It also contains all major electrolytes (potassium, magnesium, chloride and sodium), plus over 72 verified ionic minerals and trace minerals from ConcenTrace®, which accelerates assimilation and absorption of vitamins and nutrients.Electrolyte Stamina Power Pak, Orange, Trace Minerals, 32 Ct Packs, 0.23 oz Each Pack
Electrolytes are needed to maintain proper fluid balance and to optimize your energy levels so you can function at your best. Electrolyte Stamina Power Pak is an easy-to-fix high performance energy drink with no caffeine, artificial stimulants or artificial ingredients. This formula contains 1200 mg of Vitamin C, an essential anti-oxidant for people who are active and on the go. It also contains all major electrolytes (potassium, magnesium, chloride and sodium), plus over 72 verified ionic minerals and trace minerals from ConcenTrace®, which accelerates assimilation and absorption of vitamins and nutrients.Electrolyte Stamina Power Pak, Raspberry, Trace Minerals, 32 Ct Packs, 0.23 oz Each Pack
Electrolytes are needed to maintain proper fluid balance and to optimize your energy levels so you can function at your best. Electrolyte Stamina Power Pak is an easy-to-fix high performance energy drink with no caffeine, artificial stimulants or artificial ingredients. This formula contains 1200 mg of Vitamin C, an essential anti-oxidant for people who are active and on the go. It also contains all major electrolytes (potassium, magnesium, chloride and sodium), plus over 72 verified ionic minerals and trace minerals from ConcenTrace®, which accelerates assimilation and absorption of vitamins and nutrients.Electrolyte Stamina Tablets, Trace Mineral Research, 90 Tabs
Electrolyte Stamina Tablets are a high performance energy nutritional supplement, developed specifically for athletes or other people who experience a lot of fluid loss. Electrolyte Stamina Tablets replenish your body's lost nutrients that help conduct the electrical energies and balance fluid absorption and pressure throughout the body so you can feel recharged. In fact, by taking Electrolyte Stamina Tablets after a hard workout (or during periods of hot weather), it is guaranteed that you will feel a difference within 60 minutes or they will refund your money with no questions asked. Other electrolyte products consist of only a few electrolytes. This Electrolyte Stamina formula is packed with not only the major electrolytes, but all the minerals in electrolyte forma and balance - with no sugar or sucrose. so you get the natural goodness of every mineral and trace mineral as they interact in perfect balance to help maintain optimum health. It is a totally natural way to replace lost nutrients, and help you re-energize. Suggested Use: 4-10 tablets daily, depending on activity, divided with meals and before and after periods of physical activity. Take with large amounts of fluid.Essential Electrolytes, Electrolyte Supplement, pH 6.8, 100 Caps
Maximize Muscle Response and Function with NutriBiotic Essential Electrolyte Supplement.40,000 Volts Electrolyte Concentrate, Trace Minerals, 8 fl. oz.
40,000 Volts Electrolyte Concentrate is an electolyte dietary supplement, the Only Liquid Electrolyte Made with Concentrace ® Ionic trace minerals. Helps boost stamina, energy, and endurance lost through electrolyte depletion. Helps maintain proper mineral balance. Aids vitality and overall health nutritionally with natural, soluble, ionic minerals and trace minerals. 40,000 Volts! Liquid Electrolyte Concentrate can turn any drink into an electrolyte drink. Add 1 teaspoon (approximately 80 drops) to a large glass of juice or other drink anytime electrolyte replacement is desired. 40,000 Volts! is created by blending Concentrace® Trace Mineral Drops and Inland Sea Water in a special base of Liquid Potassium citrate and vitamin C. to make a high potency electrolyte supplement.Fulvic Mineral Complex, Vital Earth, 32 fl. oz.
Vital Earth's Fulvic Mineral Complex is nature's perfect vehicle to carry precious minerals and nutrients directly into the cells. It energizes and balances cells and helps stimulate the natural production of enzymes. It is one of the most powerful antioxidants and free radical scavengers known. Vial Earth's Fulvic Mineral Complex is a complete organic source of over 70 plant derived minerals, trace elements, and amino acids. Minerals in their proper form are essential for many metabolic functions, and provide the catalyst that allow vitamins to be utilized. This is the good stuff! And it tastes good straight from the bottle. No bitter metallic after taste. Fulvic Mineral Complex provides over 70 plant derived minerals and trace elements in their unaltered, ionic form, any less would be inadequate. Plant derived means there are no toxic metal or clay based minerals in our product, which translates to no toxic heavy metal buildup ever. The high fulvic acid content increases retention, absorption, and utilization of all your nutrients; as well as making Fulvic Mineral Complex one of the most powerful detoxers available. Fulvic Mineral Complex's unique ionic bond is exceptional in its ability to give you more energy, better sleep and memory function.Inland Sea Water, Pure, Kosher, Trace Minerals, 16 fl. oz.
Body-Balanced, Full Spectrum, Liquid Ionic Mineral & Trace Mineral Nutritional Supplement. A naturally concentrated sea water product from Utah's inland sea.ZMA Anabolic Sports Recovery, NOW Foods, 90 Caps
ZMA Anabolic Sports Recovery is a synergistic combination of Zinc and Magnesium designed to maximize absorption and promote recovery from exercise.Herbal Remedies: Electrolyte Drinks & Supplements
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HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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