Hyperemesis Gravidarum (Severe Nausea & Vomiting During Pregnancy)

Overview

What is hyperemesis gravidarum?

Hyperemesis gravidarum is an uncommon disorder in which extreme, persistent nausea and vomiting occur during your pregnancy. This condition might lead to dehydration.

Symptoms and Causes

What causes hyperemesis gravidarum?

The condition might be caused by rapidly rising serum levels of hormones such as HCG (human chorionic gonadotropin) and estrogen. Extreme nausea and vomiting during pregnancy might indicate a multiple pregnancy (you’re carrying more than one baby) or hydatidiform mole (abnormal tissue growth that is not a true pregnancy).

What are the symptoms of hyperemesis gravidarum?

Hyperemesis gravidarum usually occurs during the first trimester of your pregnancy. You might have hyperemesis gravidarum if you’re pregnant and you vomit:

  • More than three to four times per day.
  • So much that you lose more than 10 pounds.
  • So much that you feel dizzy and lightheaded.
  • So much that you become dehydrated.

What are the risk factors for hyperemesis gravidarum?

A risk factor is something that increases your chance of getting a disease or condition. Risk factors do not necessarily mean that you'll develop a condition.

In the case of hyperemesis gravidarum, the following are risk factors:

  • Hyperemesis gravidarum during an earlier pregnancy.
  • Being overweight.
  • Having a multiple pregnancy.
  • Being a first-time mother.
  • The presence of trophoblastic disease, which involves the abnormal growth of cells inside the uterus.

Diagnosis and Tests

How is hyperemesis gravidarum diagnosed?

A healthcare provider will ask about symptoms, take a medical history and perform a physical exam. In addition, the healthcare provider might order certain lab tests to help in making a diagnosis.

Management and Treatment

How is hyperemesis gravidarum treated?

The type of treatment that is required depends on how ill you become. Possible treatments might include:

  • Preventive measures: These might include a pressure-point wristband — similar to those used for motion sickness — vitamin B6 and/or ginger.
  • Small frequent meals: Nausea and vomiting might be treated with dry foods (such as crackers) and small, frequent meals.
  • Intravenous fluids: It is important for a pregnant woman to maintain her fluid intake. Intravenous (IV) fluids might be needed if a woman continues to vomit throughout pregnancy. In severe cases, the woman might require hospitalization and given IV fluids. IV fluids might be discontinued when a woman is able to take in fluids by mouth.
  • Total parenteral nutrition: The most severe cases of hyperemesis gravidarum might require that complex, balanced solutions of nutrients be given through an IV throughout pregnancy. This is called total parenteral nutrition (TPN).
  • Medicines: Medicine to prevent nausea is used when vomiting is persistent and poses possible risks to the mother or baby. If a woman cannot take medicines by mouth, the drugs might be administered through an IV or a suppository. Medicines used to prevent nausea include Promethazine, Meclizine and Droperidol.

Prevention

Can hyperemesis gravidarum be prevented?

Although there are no known ways to completely prevent hyperemesis gravidarum, the following measures might help keep morning sickness from becoming severe:

  • Eating small, frequent meals.
  • Eating bland foods.
  • Waiting until nausea has improved before taking iron supplements.
  • Using a pressure-point wrist band, vitamin B6 and/or ginger, as recommended by a healthcare provider.

Outlook / Prognosis

Is hyperemesis gravidarum fatal?

No. It does not threaten the life of either you or your baby.

Can hyperemesis gravidarum go away on its own?

Hyperemesis gravidarum will (usually) only affect you during your first trimester.

Last reviewed by a Cleveland Clinic medical professional on 12/02/2020.

References

  • American Pregnancy Association. Hyperemesis Gravidarum. (http://americanpregnancy.org/pregnancy-complications/hyperemesis-gravidarum/) Accessed 11/24/2020.
  • The HER Foundation. About Hyperemesis Gravidarum. (http://www.helpher.org/hyperemesis-gravidarum/) Accessed 11/24/2020.

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