Pregnancy is often a wonderful, joyous experience; but it can also lead to several medical complications; like severe, persistent nausea and vomiting (called hyperemesis gravidarum) and anaemia caused by iron deficiency. These two complications are relatively common and can be seen in women with and without other medical conditions.
Hyperemesis gravidarum and iron-deficiency anaemia are usually not life-threatening conditions in pregnant women, but they can lead to micronutrient deficiencies. In hyperemesis gravidarum a woman may vomit so much that she has an electrolyte imbalance and doesn’t retain enough food to derive energy from. In iron-deficiency anaemia, a pregnant woman doesn’t eat enough iron-containing foods (like meat, seafood, leafy-greens, and tomatoes) and lacks the iron needed to make haemoglobin, which supplies oxygen to both the mom’s and babies’ tissues.
The symptoms of persistent vomiting (hyperemesis gravidarum) in pregnancy include:
The symptoms of iron-deficiency anaemia in pregnancy include:
Persistent nausea and vomiting in pregnancy (hyperemesis gravidarum) is thought to be caused by an increase in a pregnancy hormone, HCG. HCG gets released by the placenta and is often used as a marker of the health of the foetus. In cases where HCG rises very high or very quickly, nausea and vomiting may become more severe than typical “morning sickness” and can put the pregnant mother and baby at risk for more serious complications. HCG can rise very high in twin, triplet, or multiples pregnancies. HCG can also be very high in molar pregnancies, a type of non-viable pregnancy where an inappropriate number of eggs or sperm combine to produce a hydatidiform mole. Hydatidiform moles are made up of placental tissue, and very little foetal tissue.
Iron-deficiency anaemia in pregnancy usually occurs because a pregnant woman isn’t getting enough iron in her diet. Pregnancy is a time of increased iron utilization, because the growing foetus needs lots of iron to make its own haemoglobin, so a pregnant mother must have enough iron for two. Women of reproductive age tend to be anaemic before even getting pregnant, due to blood loss from their periods (menses). So, iron-deficiency anaemia is relatively common during pregnancy, and iron supplementation is often required to manage it.
Risk factors for hyperemesis gravidarum include:
Risk factors for iron-deficiency anaemia in pregnancy include:
Hyperemesis gravidarum is diagnosed by a doctor’s assessment. Sometimes blood tests will also be done to check the levels of electrolytes like potassium and sodium in your body. These can indicate how dehydrated you are or how severe the vomiting is.
Iron-deficiency anaemia is diagnosed with blood tests, and studies that can determine the iron content of the blood.
Hyperemesis gravidarum is treated with antiemetics (drugs that reduce vomiting). You also might get fluids and electrolytes put directly into your bloodstream (IV fluids).
Iron-deficiency anaemia is treated with iron supplements, whether as a pill or injection. If the iron-deficiency is severe enough, you may require a blood transfusion.