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Hyperemesis Gravidarum (HG)⁠ ⁠ Not the same as morning sickness in pregnancy! ⁠ ⁠ It is persistent nausea and vomiting associated with dehydration, weight loss and electrolyte changes in the blood. It can have a significant impact on quality of life and mental health of women. ⁠ ⁠ It can affect any pregnancy but risk factors are a twin pregnancy or a molar (abnormally formed) pregnancy. ⁠ ⁠ It is often expected that the symptoms improve after 12 weeks but this is not true for everyone and can in fact last the whole pregnancy. ⁠ ⁠ Investigations that should be organised include a blood test and an early pregnancy scan. These will help frame treatment.⁠ ⁠ 1st line management is with anti-sickness tablets. Six different tablets have been proven to be safe in pregnancy and can be started by your GP or gynaecologist. A combination of these medications can also be tried. ⁠ ⁠ 2nd line management should be considered where dehydration persists with anti-sickness tablets. It includes intravenous fluids and anti-sickness in a hospital setting with high dose vitamins folic acid and vitamin B. If still uncontrolled steroids and anti-acid tablets can also be used. ⁠ ⁠ Acupuncture has been shown to help compliment the management.⁠ Holistic care of HG is very important due to its impact! Care with midwives, dieticians, pharmacists, psychiatrists and others should be considered to ensure adequate support for the patient. ⁠ ⁠ If your pregnancy is complicated with HG please seek help early and do not suffer in silence. HG should not be normalised. It should be recognised and treated.⁠ ⁠ 📸unknown