Table of ContentsView AllTable of ContentsSymptoms of Hyperemesis GravidarumCausesRisk FactorsDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms of Hyperemesis Gravidarum
Causes
Risk Factors
Diagnosis
Treatment
Coping
Hyperemesis gravidarum is extreme, persistent nausea and vomiting duringpregnancy. It is not the same asmorning sickness, which refers to mild nausea and vomiting that often occur in the first three months of pregnancy. Hyperemesis gravidarum is less common and more severe. It can occur during any pregnancy, but some people, such as those who had this condition in previous pregnancies, may be more at risk.
People with hyperemesis gravidarum may vomit more than three to four times a day. They may vomit so much that they feel dizzy and lightheaded. This condition can lead to weight loss,dehydration, and electrolyte imbalance.
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About 70% of people have nausea and vomiting during pregnancy, often in early pregnancy and most often in the morning—hence the name “morning sickness.” Hyperemesis gravidarum, a more severe form of nausea and vomiting, is estimated to affect 0.3% to 10.8% of pregnancies.This condition is the most severe form of nausea and vomiting during pregnancy, and it often begins before the 20thweek of pregnancy.
Symptoms of hyperemesis gravidarum are similar to those of morning sickness, but they are more severe. They include:
The severity of this condition can result in a number of complications, including:
Hyperemesis Gravidarum Can Affect Infants TooSome complications that may occur in babies as a result of hyperemesis gravidarum include:Lower birth weightSmaller sizeIncreased risk of developmental delays
Hyperemesis Gravidarum Can Affect Infants Too
Some complications that may occur in babies as a result of hyperemesis gravidarum include:Lower birth weightSmaller sizeIncreased risk of developmental delays
Some complications that may occur in babies as a result of hyperemesis gravidarum include:
The exact cause of hyperemesis gravidarum isn’t clear, but some evidence suggests that hormones may play a role:
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People who have the following conditions or characteristics may be more prone to developing hyperemesis gravidarum:
Diagnosis of hyperemesis gravidarum is based primarily on the severity of symptoms. Typically, signs that pregnancy nausea and vomiting are progressing to hyperemesis gravidarum appear between the fourth and sixth week of pregnancy. Symptoms may improve between the 14thand 20thweek. About 20% of people will have this condition for the duration of their pregnancies.
Your healthcare provider will ask you about your symptoms and perform a physical exam to rule out other potential causes of your symptoms. Lab tests may be done to monitor your health, especially to monitor your fluid and electrolyte levels. Your healthcare provider may order blood or urine tests to monitor the following:
Abnormal results from these tests could indicate dehydration, malnutrition, or deficiencies. Apregnancy ultrasoundwill be done to see if you are carrying twins or more babies and if you have a hydatidiform mole.
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Treatment focuses on alleviating severe symptoms in many cases. This usually involves hospitalization and the administration of intravenous fluids and nutrients to make up for those lost through vomiting. In the most severe cases, complex, balanced solutions of nutrients have to be given through an IV throughout pregnancy. This is called total parenteral nutrition.
If nausea and vomiting continue after fluid and nutrient replacement, antiemetics and other medications may be used, including:
There are also holistic methods, treatments, and therapies that may help alleviate the symptoms of hyperemesis gravidarum. These might include a pressure-point wristband similar to those used for motion sickness, vitamin B6 supplement, and ginger supplement. Nausea and vomiting may also be treated with dry foods such as crackers, and small, frequent meals.
When to Call Your Healthcare ProviderCall your healthcare provider if you are pregnant and have severe nausea and vomiting or if you have any of the following symptoms:Signs of dehydrationUnable to tolerate any fluids for over 12 hoursLightheadedness or dizzinessBlood in the vomitAbdominal painWeight loss of more than 5 pounds
When to Call Your Healthcare Provider
Call your healthcare provider if you are pregnant and have severe nausea and vomiting or if you have any of the following symptoms:Signs of dehydrationUnable to tolerate any fluids for over 12 hoursLightheadedness or dizzinessBlood in the vomitAbdominal painWeight loss of more than 5 pounds
Call your healthcare provider if you are pregnant and have severe nausea and vomiting or if you have any of the following symptoms:
A number of considerations are key to managing hyperemesis gravidarum:
You may want to avoid certain things that can trigger nausea and vomiting, such as:
Take advantage of the times you feel better to eat and drink, and increase fluid intake during times of the day when you don’t feel nauseated. Seltzer, ginger ale, or other sparkling drinks may help.
Psychological and emotional support are key too. People who suffer from hyperemesis gravidarum in their pregnancy may have feelings of anxiety or depression, guilt, or trauma. A compassionate and caring clinician is essential, as are support and education for family and other support members.
A Word From Verywell
Nausea and vomiting may be usual pregnancy symptoms for many people, but for some, the symptoms can be extreme and lead to serious complications. Hyperemesis gravidarum isn’t just an exaggeration of a normal pregnancy problem. It’s a serious condition that could result in hospitalization, severe illness, and pregnancy loss. People who have this condition may need to try a variety of medications and treatments to find relief, and having a strong support system in place is crucial to coping.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fejzo MS, Trovik J, Grooten IJ, et al.Nausea and vomiting of pregnancy and hyperemesis gravidarum.Nat Rev Dis Primers5, 62 (2019). doi: 10.1038/s41572-019-0110-3.National Organization for Rare Disorders.Hyperemesis gravidarum.HER Foundation.Gastrointestinal complications.HER Foundation.Neurological Complications.McCarthy FP, Lutomski JE, Greene RA.Hyperemesis gravidarum: current perspectives.Int J Womens Health. 2014 Aug 5;6:719-25. doi:10.2147/IJWH.S37685Fejzo MS, Arzy D, Tian R, MacGibbon KW, Mullin PM.Evidence GDF15 Plays a Role in Familial and Recurrent Hyperemesis Gravidarum.Geburtshilfe Frauenheilkd. 2018 Sep;78(9):866-870. doi:10.1055/a-0661-0287Cleveland Clinic.Hyperemesis gravidarum.HER Foundation.Assess & diagnose.MedlinePlus.Hyperemesis gravidarum.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fejzo MS, Trovik J, Grooten IJ, et al.Nausea and vomiting of pregnancy and hyperemesis gravidarum.Nat Rev Dis Primers5, 62 (2019). doi: 10.1038/s41572-019-0110-3.National Organization for Rare Disorders.Hyperemesis gravidarum.HER Foundation.Gastrointestinal complications.HER Foundation.Neurological Complications.McCarthy FP, Lutomski JE, Greene RA.Hyperemesis gravidarum: current perspectives.Int J Womens Health. 2014 Aug 5;6:719-25. doi:10.2147/IJWH.S37685Fejzo MS, Arzy D, Tian R, MacGibbon KW, Mullin PM.Evidence GDF15 Plays a Role in Familial and Recurrent Hyperemesis Gravidarum.Geburtshilfe Frauenheilkd. 2018 Sep;78(9):866-870. doi:10.1055/a-0661-0287Cleveland Clinic.Hyperemesis gravidarum.HER Foundation.Assess & diagnose.MedlinePlus.Hyperemesis gravidarum.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fejzo MS, Trovik J, Grooten IJ, et al.Nausea and vomiting of pregnancy and hyperemesis gravidarum.Nat Rev Dis Primers5, 62 (2019). doi: 10.1038/s41572-019-0110-3.National Organization for Rare Disorders.Hyperemesis gravidarum.HER Foundation.Gastrointestinal complications.HER Foundation.Neurological Complications.McCarthy FP, Lutomski JE, Greene RA.Hyperemesis gravidarum: current perspectives.Int J Womens Health. 2014 Aug 5;6:719-25. doi:10.2147/IJWH.S37685Fejzo MS, Arzy D, Tian R, MacGibbon KW, Mullin PM.Evidence GDF15 Plays a Role in Familial and Recurrent Hyperemesis Gravidarum.Geburtshilfe Frauenheilkd. 2018 Sep;78(9):866-870. doi:10.1055/a-0661-0287Cleveland Clinic.Hyperemesis gravidarum.HER Foundation.Assess & diagnose.MedlinePlus.Hyperemesis gravidarum.
Fejzo MS, Trovik J, Grooten IJ, et al.Nausea and vomiting of pregnancy and hyperemesis gravidarum.Nat Rev Dis Primers5, 62 (2019). doi: 10.1038/s41572-019-0110-3.
National Organization for Rare Disorders.Hyperemesis gravidarum.
HER Foundation.Gastrointestinal complications.
HER Foundation.Neurological Complications.
McCarthy FP, Lutomski JE, Greene RA.Hyperemesis gravidarum: current perspectives.Int J Womens Health. 2014 Aug 5;6:719-25. doi:10.2147/IJWH.S37685
Fejzo MS, Arzy D, Tian R, MacGibbon KW, Mullin PM.Evidence GDF15 Plays a Role in Familial and Recurrent Hyperemesis Gravidarum.Geburtshilfe Frauenheilkd. 2018 Sep;78(9):866-870. doi:10.1055/a-0661-0287
Cleveland Clinic.Hyperemesis gravidarum.
HER Foundation.Assess & diagnose.
MedlinePlus.Hyperemesis gravidarum.
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