Hyperemesis Gravidarum (Severe Morning Sickness)
Severe, persistent nausea and vomiting causing dehydration and weight loss.
Affects: 0.5-2% of pregnancies
Overview
Hyperemesis gravidarum (HG) is severe morning sickness causing persistent vomiting, dehydration, and weight loss of 5% or more of pre-pregnancy weight. It's much more serious than typical morning sickness.
Women with HG often cannot keep down any food or fluids, leading to malnutrition and dehydration. Hospitalization for IV fluids and medications is common. The condition typically begins early in pregnancy and may last throughout.
HG is physically and emotionally exhausting. While it doesn't usually harm the baby directly, maternal dehydration and malnutrition can cause complications. Treatment focuses on preventing dehydration and providing adequate nutrition.
🩺 Symptoms
- •Severe, persistent nausea
- •Vomiting more than 3-4 times per day
- •Unable to keep food or fluids down
- •Weight loss of 5% or more
- •Dehydration (dark urine, dizziness, rapid heart rate)
- •Feeling faint or weak
- •Headaches
- •Inability to perform daily activities
- •Excessive salivation
- •Low blood pressure
🔍 Causes
- →Exact cause unknown
- →Very high hCG hormone levels
- →Multiple pregnancy (twins)
- →Molar pregnancy
- →Genetic predisposition
- →First pregnancy or new partner
- →History of motion sickness
- →Migraine history
⚠️ Risk Factors
- •HG in previous pregnancy (up to 80% recurrence)
- •Multiple pregnancy (twins, triplets)
- •Molar pregnancy
- •Female fetus
- •Family history of HG
- •History of eating disorders
- •Thyroid problems
- •First pregnancy
- •Young maternal age
🔬 Diagnosis
- →Persistent vomiting with weight loss
- →Signs of dehydration
- →Electrolyte imbalances on blood tests
- →Ketones in urine
- →Ruling out other causes (gallbladder, appendicitis, etc.)
- →Ultrasound to rule out molar pregnancy or multiples
- →Thyroid tests
💊 Treatment
- ✓IV fluids for hydration
- ✓Anti-nausea medications (ondansetron, promethazine, metoclopramide)
- ✓Vitamin B6 and doxylamine combination
- ✓Thiamine supplementation to prevent deficiency
- ✓Small, frequent meals when able to eat
- ✓BRAT diet (bananas, rice, applesauce, toast)
- ✓Ginger or peppermint
- ✓Hospitalization if severe
- ✓Feeding tube or TPN if unable to eat for extended period
- ✓Home IV therapy
- ✓Emotional support and counseling
🛡️ Prevention
- →Cannot be prevented
- →Early treatment of nausea may prevent progression
- →Stay hydrated
- →Eat small, frequent meals
- →Avoid triggers
- →If previous HG, early intervention and medications
⚠️ Potential Complications
- !Severe dehydration
- !Electrolyte imbalances
- !Malnutrition
- !Weight loss
- !Wernicke encephalopathy (thiamine deficiency)
- !Muscle wasting
- !Depression and anxiety
- !PTSD
- !Preterm birth if severe
- !Low birth weight
- !Esophageal tears from vomiting
- !Tooth enamel erosion
🚨 When to Call Your Doctor
Contact your healthcare provider immediately if you experience:
- ⚠Unable to keep fluids down for 24 hours
- ⚠Vomiting more than 3-4 times daily
- ⚠Losing weight
- ⚠Dark urine or no urination for 8+ hours
- ⚠Dizziness or fainting
- ⚠Rapid heartbeat
- ⚠Severe weakness
- ⚠Vomiting blood
- ⚠Thoughts of harming self or baby
Related Conditions
This information is for educational purposes and should not replace medical advice. Always consult your healthcare provider for personalized guidance.