Hyperemesis gravidarum is the medical term for severe nausea and vomiting during pregnancy. The symptoms can be very uncomfortable. You might vomit more than three times a day, become dehydrated, feel constantly dizzy and lightheaded and lose weight. Fortunately there are treatments available, including medicines to prevent nausea.
Hyperemesis gravidarum (HG) is when extreme, persistent nausea and vomiting occur during your pregnancy. It can lead to weight loss and dehydration. Hyperemesis gravidarum is sometimes called severe morning sickness.
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Morning sickness is extremely common during pregnancy — up to 80% of people report experiencing it. It’s not as severe as hyperemesis gravidarum and doesn’t cause dehydration or weight loss. Morning sickness may cause occasional vomiting and nausea, but you should still be able to keep food and liquids down most of the day. It tends to subside or disappear completely after 12 weeks of pregnancy (the first trimester).
Hyperemesis gravidarum causes you to vomit several times per day. This can eventually lead to weight loss and dehydration. Symptoms of HG often last longer than morning sickness. You might need treatment in a hospital with IV fluids (fluids given intravenously, or through your vein) if you become dehydrated.
HG is uncommon. It affects less than 3% of pregnant people.
Hyperemesis gravidarum usually occurs during the first trimester of your pregnancy (beginning around six weeks of pregnancy). Symptoms can last weeks, months or up until delivery. They can be debilitating, preventing you from doing your normal activities.
The most common symptoms of hyperemesis gravidarum are:
Other less common symptoms include:
Experts don’t know for sure what causes hyperemesis gravidarum. However, rising hormone levels are most likely what causes it. Specifically, HCG (human chorionic gonadotropin), which your body makes during pregnancy — very quickly and in large amounts. HCG levels peak around 10 weeks of pregnancy, which is when most people report having the most severe symptoms. Estrogen, another hormone that increases during pregnancy, may also play a role in causing nausea and vomiting.
Some people may have a higher likelihood of developing HG. Risk factors for hyperemesis gravidarum include:
Lack of fluid and nutrients (malnourishment) cause the most complications related to HG. When you’re vomiting so frequently, it’s hard for your body to get the vitamins and nutrients it needs. This could lead to complications like preterm birth or low birth weight. You may also have bleeding in your throat or other side effects from excessive vomiting.
Your healthcare provider will ask about your symptoms and medical history and perform a physical exam. This includes checking your weight to see if you’ve lost too much weight.
Your provider might order blood and urine tests to check you for dehydration. They may also use ultrasound to see if you’re carrying more than one fetus or have signs of GTD. Your provider may rule out other causes of vomiting such as gastrointestinal illnesses.
Treatment depends on the severity of your symptoms. Be sure to discuss all your treatment options with your pregnancy care provider.
For very mild cases, possible treatments could include:
If your vomiting is excessive and you become dehydrated, you might need to stay in the hospital. Some of the treatments for moderate to severe hyperemesis gravidarum include:
Be sure to talk to your provider about the risks of taking certain medications for HG during pregnancy.
Yes. It’s possible that your symptoms subside after the first trimester. It’s also possible that your symptoms last your entire pregnancy. Many people say their symptoms get less severe as time goes on. The good news is that it almost always goes away after delivery.
No, you can’t prevent hyperemesis gravidarum. Knowing if you’re at risk is the best thing you can do to prepare yourself.
If your provider is monitoring your pregnancy and you’re receiving treatment, HG usually doesn’t affect the fetus. In rare cases, losing too much weight or being dehydrated can cause your baby to be born at a lower birth weight.
Most people have no effects of hyperemesis gravidarum after delivery. While you’re at higher risk for having the condition in subsequent pregnancies, you shouldn’t feel any symptoms once your baby is born. People that receive treatment for HG typically deliver healthy babies.
Yes, your provider will likely treat your pregnancy as high-risk. This means your provider will monitor your pregnancy closer to ensure there are no complications.
The best thing you can do for hyperemesis gravidarum is to get treatment from your provider. Only your provider can treat the severe symptoms of HG like dehydration.
Follow your provider’s advice on other things you can do to help yourself feel better at home. Some possible examples of things you can do include:
Severe vomiting or being unable to keep food and liquids down isn’t a normal part of pregnancy. It may require medical care. Call your pregnancy care provider right away if you:
A note from Cleveland Clinic
Hyperemesis gravidarum is extreme morning sickness and causes you to vomit several times per day during pregnancy. In severe cases, it leads to dehydration and may cause premature birth. With treatment, most people can find relief from their symptoms and get the nourishment they need to support their pregnancy. Talk to your healthcare provider if you feel extremely nauseous or vomit several times a day during pregnancy. They can help you feel better and get the nutrients you need.
Last reviewed by a Cleveland Clinic medical professional on 02/21/2023.
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