Hyperemesis Gravidarum

(Severe Morning Sickness; Persistent Vomiting of Pregnancy; HG)

Definition

Hyperemesis gravidarum (HG) is severe nausea and vomiting during pregnancy. It is not common.

Causes

The cause is not known. There are many thoughts about what may cause it, such as:

The Brain May Be the Cause of Nausea
Brainstem and brain

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Risk Factors

HG is more common in young pregnant women. It is also more common in pregnant women who are Asian or Black.

Other things that may raise the risk are:

  • HG during prior pregnancies
  • Prior molar pregnancy—a growth of abnormal tissue in the womb
  • A mother or sister with HG
  • A multiples pregnancy
  • First-time pregnancy
  • Having certain health problems, such as migraines or motion sickness

Symptoms

Problems may be:

  • Nausea and vomiting in early pregnancy
  • Weight loss
  • Lightheadedness and fainting

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. Blood and urine tests may also be done.

Other tests may be:

  • Blood tests
  • Urine tests

Treatment

The goal of treatment is to manage symptoms to prevent weight loss and dehydration. Choices are:

  • Lifestyle changes, such as eating frequent small meals of bland, dry, high-protein foods
  • Anti-nausea medicine
  • Vitamin B6 to ease nausea

Prevention

The risk of this problem may be lowered by taking prenatal vitamins for one month before becoming pregnant.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

HER Foundation
http://www.helpher.org

CANADIAN RESOURCES:

The Canadian Women's Health Network
http://www.cwhn.ca

The Society of Obstetricians and Gynaecologists of Canada (SOGC)
http://sogc.org

REFERENCES:

About hyperemesis gravidarum. HER Foundation website. Available at: http://www.helpher.org/hyperemesis-gravidarum. Accessed November 24, 2020.

American College of Obstetrics and Gynecology. Practice Bulletin 189: nausea and vomiting of pregnancy. Obstet Gynecol 2018 Jan;131(1):e15.

Nausea and vomiting in pregnancy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/nausea-and-vomiting-in-pregnancy. Accessed November 24, 2020.

Nausea and vomiting of pregnancy. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2018/01/nausea-and-vomiting-of-pregnancy. Accessed November 24, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 11/24/2020