What is dehydration?
Dehydration occurs due to excessive loss of body water along with salts (electrolytes). It can arise with intense vomiting, like during pregnancy (morning sickness or hyperemesis gravidarum in more severe cases) and with diarrhea. Although dehydration can be life threatening to any person, of any age and health status, there is a greater risk in pregnant women who lose large volumes of fluid and electrolytes with vomiting and profuse diarrhea.
Depending upon the degree of dehydration, it can clinically be classified as mild, moderate and severe. Mild and most moderate varieties of dehydration are easily managed with oral fluid replacement. Few cases of moderate and all cases of severe dehydration require parenteral (intravenous) fluid replacement. Severe cases of dehydration if untreated may cause shock (hypovolemic) and death.
Symptoms of Dehydration
Dehydration is one of the major complications of vomiting and diarrhea. Therefore it is important for pregnant women to be aware of the signs and symptoms in order to seek medical attention as soon as possible. The symptoms usually depend upon the severity of dehydration.
Mild to moderate dehydration presents as :
- Dryness of mouth.
- Increased thirst.
- Dryness of the eye (decreased tears in the eyes).
- Dryness of the skin.
- Decreased elasticity of the skin.
- Reduced urine output.
Despite all the above symptoms patient remains alert and the mental status is not compromised.
Severe dehydration presents with :
- Extreme thirst but inability to drink due to increased tiredness or unconsciousness.
- Increased irritability, fatigue and confusion.
- Severe drying of mouth and skin.
- Almost complete loss of skin elasticity.
- No sweating.
- Complete absence of urination due to kidney failure.
- Sunken eyes.
- Increase in pulse rate.
- Low blood pressure.
- Epileptic fits (seizure) can occur.
In severe cases there is unconsciousness and if medical treatment is forthcoming, it may ultimately lead to death.
Causes of Dehydration
In dehydration, the body loses excessive fluid and electrolytes. There are various causes of dehydration apart from vomiting and diarrhea during pregnancy.
- Hot and humid weather.
- Prolonged exercise, traveling or hiking in the sun without adequate water intake.
- Severe blood loss due to trauma or fracture.
- High temperature (fever) with profuse sweating.
- Severe burn injury covering a wide area of the body.
- Excessive alcohol consumption.
- Infectious diseases, especially an infection of the digestive tract such as cholera or shigellosis.
- In some cases of diabetes mellitus there may be dehydration.
- Excessive urine production due to certain drug intake diuretics, some psychiatric drugs
Treatment of Dehydration
Replacement of fluids and electrolytes are the mainstay of treatment. This can be done with oral rehydration solutions – specially formulated drinks containing the optimal concentration of salts. The moment vomiting ceases, a person must continue with a regular bland diet of semi-solid and solid foods. Certain drinks like carbonated, caffeinated beverages, gelatins should be avoided. Plain water is not adequate in treating dehydration. If there is severe dehydration then fluids and electrolytes may need to be delivered through an intravenous (IV) drip. Hospitalization of pregnant women is usually necessary to monitor both mother and baby.