Secondary Care for Hyperemesis Gravidarum
In Hospital Care for Patients with Hyperemesis Gravidarum
Nausea and Vomiting in Pregnancy (NVP) and Hyperemesis Gravidarum (HG) can be particularly isolating for women experiencing them; in first pregnancies it is usually a complete shock to find themselves feeling so ill at what was anticipated to be an exciting and enjoyable time of life. It is important that Healthcare professionals take reporting of symptoms seriously so that women can feel understood and know that the condition is a valid one. Until very recently it was surprising how many doctors didn't know what hyperemesis gravidarum is, let alone the appropriate treatment of it. Sadly, studies have found that many hospital staff, including doctors, nurses and midwives, have a prevailing view that women admitted for hyperemesis gravidarum are 'wasting their time' and that the condition is psychosomatic (Power et al 2010, Dean 2016, Sykes et al 2013). However, before the introduction of IV therapy, hyperemesis gravidarum was the leading cause of death for women in early pregnancy!
The Pregnancy Sickness Support Trust is not able to provide information on prescribing for women with hyperemesis gravidarum, and all practice should be in accordance with local hospital policy or the national RCOG guidelines. However we have provided information on current treatments and we have a resource page with up to date research and references for you to access when treating women with this condition.
Following are some basic tips and information on how to improve the care and experience of women with hyperemesis gravidarum and helping women manage their symptoms.
- Be sympathetic! First time mums presenting with hyperemesis gravidarum are probably terrified about what is happening to her and having to take medication. Women are bombarded with pregnancy books which tell us we should have 'natural pregnancies' avoiding all medication. Hyperemesis usually comes as a complete shock to the sufferer, as more often then not women have never heard of it before.
- Evaluate weight loss and signs of malnutrition and dehydration.
- Provide a side room so as to reduce sensory stimulation; odour, sound, light, movement and so on can all trigger nausea and vomiting.
- Be aware that if she is already at the point of admission to hospital then she is likely to be beyond the help of ginger, acupressure and eating little and often, and she is likely to have heard about these remedies so often that suggesting them will add to her isolation and could lead to a loss of trust in medical professionals.
- Refer her to our support network for support from other sufferers.
IV Day Clinic
How to set up an IV Day Unit for women with hyperemesis gravidarum in your hospital
Treatment Pathways for rapid rehydration.
If you are a Healthcare Professional looking to set up an IV Day Unit in your hospital and would like further information now then please contact us for more information.
HG Training for Healthcare Professionals
The risk of a baby being born with a congenital abnormality - the difference between relative and absolute risk
Please note this guideline is for moderate to severe NVP symptoms rather than HG
RCOG Green-top Guideline No. 69
The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum
BMJ Clinical Update 2018
Management of severe pregnancy sickness and hyperemesis gravidarum
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