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Hyperemesis Gravidarum

Medically reviewed by Last updated on Mar 5, 2023.

What is hyperemesis gravidarum?

Hyperemesis gravidarum is a severe form of nausea and vomiting that happens during pregnancy. Hyperemesis is more severe than morning sickness. It may cause you to have nausea or vomiting all day for many days. It may also keep you from getting enough food and liquid.

What increases my risk for hyperemesis gravidarum?

The cause of hyperemesis is not known. Any of the following can increase your risk:

  • Pregnant with more than 1 baby
  • History of motion sickness or migraine headaches
  • Hyperemesis with a previous pregnancy
  • Family history of hyperemesis
  • Pregnant with a girl baby

What are the signs and symptoms of hyperemesis gravidarum?

Signs and symptoms usually begin in the first trimester (first 12 weeks). Hyperemesis often goes away during the second trimester (after 20 weeks) but may continue through the entire pregnancy.

  • Severe nausea and vomiting, and dry retching
  • Easily affected by strong smells
  • Poor appetite or change in taste
  • Symptoms of dehydration, such as dark yellow urine, dry mouth and lips, dry skin, and urinating less than usual
  • Fatigue
  • Dizziness when you stand
  • Weight loss

How is hyperemesis gravidarum diagnosed?

Your healthcare provider will examine you and check your weight. He or she will test for other problems. If no other problems are found, your provider will diagnose hyperemesis gravidarum. Blood and urine tests may show dehydration. The tests may also show how well your organs are working. You may need an ultrasound to make sure your baby is okay.

How is hyperemesis gravidarum treated and managed?

You may be admitted to the hospital if you are dehydrated. Your healthcare provider may suggest any of the following:

  • Eat small amounts of food every 1 to 2 hours. Some examples of good foods to eat include broth, toast, fruit, eggs, gelatin, or cottage cheese. Do not eat spicy or high-fat foods. Try to eat crackers before getting out of bed each morning. Foods and drinks with ginger, such as ginger ale, may help to decrease nausea and vomiting.
  • Drink liquids as directed. You may need to drink small amounts of liquid often to prevent dehydration. Ask how much liquid to drink each day and which liquids are best for you.
  • Rest when you need to. Start activity slowly and work up to your usual routine as you start to feel better.
  • Avoid things that may make hyperemesis worse. Avoid odors, heat, and humidity. Limit noise and flickering lights.
  • Medicines, vitamins, or supplements may be given to help decrease nausea and vomiting.
  • Weigh yourself daily if directed by your healthcare provider. You may need to keep a record of your daily weights for your healthcare provider. He or she may want to make sure you are not losing too much weight.

When should I seek immediate care?

  • You have signs of severe dehydration including little to no urine and dry mouth or lips.
  • You have severe stomach pain.
  • You feel too weak or dizzy to stand up.
  • You see blood in your vomit or bowel movements.

When should I contact my healthcare provider?

  • You cannot keep any food or liquid down.
  • You are losing weight.
  • You have a fever.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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