Hyperemesis Gravidarum

What is hyperemesis gravidarum?

Many women experience morning sickness (nausea) during pregnancy. This condition is usually harmless. Although morning sickness can be quite bothersome, it usually goes away within 12 weeks.

Hyperemesis gravidarum (HG) is an extreme disease that causes severe nausea and vomiting during pregnancy.

Morning sickness versus hyperemesis gravidarum

Morning sickness and HG are very different conditions. It has different complications and side effects for every pregnant woman. It is important to distinguish these two conditions in order to properly treat the symptoms.

morning sickness

Morning sickness typically includes nausea, sometimes accompanied by vomiting. These two symptoms usually go away after 12 to 14 weeks. Vomiting does not cause severe dehydration.

Morning sickness typically begins in the first month of pregnancy. It usually goes away by the third or fourth month. Pregnant women with morning sickness may experience fatigue and a slight loss of appetite. They may have difficulty performing their usual daily activities.

Hyperemesis gravidarum

HG typically includes nausea that does not go away and severe vomiting leading to severe dehydration. This does not allow you to keep any food or liquid low.

HG symptoms begin in the first six weeks of pregnancy. Nausea often does not go away. HG can be extremely debilitating and cause weeks or months of fatigue.

According to the HER Foundation, women with HG may experience a loss of appetite. They may not be able to run or perform their normal daily activities.

HG can cause dehydration and poor weight gain during pregnancy. There is no known way to prevent morning sickness or HG, but there are ways to manage the symptoms.

What are the symptoms of hyperemesis gravidarum?

HG usually starts in the first trimester of pregnancy. According to the HER Foundation, less than half of women with HG report experiencing symptoms throughout their entire pregnancy.

Some of the most common symptoms of HG include:

  • almost constant feeling of nausea
  • loss of appetite
  • vomiting more than three or four times a day
  • be thirsty
  • feeling dizzy or lightheaded
  • losing more than 10 pounds or 5 percent of your body weight due to nausea or vomiting

What causes hyperemesis gravidarum?

Almost all women experience some degree of morning sickness during their pregnancy. Morning sickness is nausea and vomiting during pregnancy. Despite its name, morning sickness isn’t limited to the morning. It can occur at any time.

Morning sickness and HG appear to be linked to human chorionic gonadotropin (hCG). This is a hormone released by the placenta during pregnancy. Your body produces a large amount of this hormone at a rapid rate in early pregnancy. These levels may continue to increase throughout your pregnancy.

Who is at risk for hyperemesis gravidarum?

Some factors that can increase your risk of getting HG include:

  • have a family history of HG
  • being pregnant with more than one baby
  • be overweight
  • being a mother for the first time

Trophoblastic disease can also cause HG. Trophoblastic disease occurs when there is abnormal cell growth within the uterus.

How is hyperemesis gravidarum diagnosed?

Your doctor will ask you about your medical history and symptoms. A standard physical examination is sufficient to diagnose most cases. Your doctor will look for general signs of HG, such as abnormally low blood pressure or a fast heart rate.

Blood and urine samples may also be needed to check for signs of thirst. Your doctor may also order additional tests to rule out gastrointestinal problems as a cause of nausea or vomiting.

An ultrasound may be necessary to find out if you are pregnant with twins or if there are any problems. This test uses sound waves to create an inside image of your body.

How is hyperemesis gravidarum treated?

HG treatment depends on the severity of your symptoms. Your doctor may recommend natural anti-nausea methods such as vitamin B6 or ginger.

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Hospitalization may be required in severe HG cases. Pregnant women who are unable to keep fluids or food low due to persistent nausea or vomiting need to get them intravenously or through an IV.

Medication is required when vomiting is a threat to the woman or child. The most commonly used anti-nausea drugs are promethazine and meclizine. You can get it as an IV or as a suppository.

Taking medication while pregnant can cause potential health problems for the baby, but in severe cases of HG, maternal dehydration poses more of a problem. Talk to your doctor about the risks associated with any treatment method.

What is the long-term outlook?

The good news is that HG symptoms will go away after delivery. However, postpartum recovery may be longer for women with HG.

Talk to your doctor and follow up with education and support groups to help you and your family cope with HG. Be sure to communicate your feelings to your doctor and your personal support system.


About hyperemesis gravidarum. (2013).

hCG levels. (2017).

Hyperemesis gravidarum (severe nausea and vomiting during pregnancy). (2016).

Severe morning sickness (hyperemesis gravidarum). (2014).

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