Hyperemesis Gravidarum

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

A lot of expecting mothers suffer from morning sickness (nausea) when pregnant. This condition is usually harmless. While it can be quite uncomfortable, it generally goes away within 12 weeks.

But for a handful of people, it’s a lot more intense. About 3% of pregnant women experience a condition called hyperemesis gravidarum. There’s no cure for this, but it’s temporary, and there are ways to manage it.

You vomit a lot, sometimes almost always when you have hyperemesis gravidarum. This can result in complications such as dehydration and weight loss. Morning illness often stops by the end of the first trimester, but hyperemesis gravidarum usually lasts longer.

It generally occurs between the 4th and 6th weeks of pregnancy and, perhaps, at its worst, between weeks 9 and 13. Vomiting is so severe and most women are unable to perform their typical daily activities. Symptoms usually get better at the 20th week for some expecting mothers.

Doctors are not certain of what causes it, but they believe it’s attributable to increased hormone levels. Women who have had the condition during their first pregnancy have a higher chance of getting it again during their next pregnancy.

There are no known ways to prevent it, although taking a multivitamin before you get pregnant may help a little bit.

Morning sickness vs. hyperemesis gravidarum

Morning sickness and HG are different conditions. They result in various complications and side effects for every individual pregnant woman. It’s important to differentiate between these two conditions to treat symptoms properly.

While Morning sickness usually includes nausea that can be accompanied by vomiting. Morning sickness generally starts in the first weeks of pregnancy. But these symptoms typically disappear after 12 to 14 weeks into the pregnancy.

Also, this vomiting doesn’t result in severe dehydration. Pregnant women with morning sickness can feel tired and experience a slight loss of appetite. They may find it challenging to carry out their daily activities.

Hyperemesis gravidarum usually includes nausea and severe vomiting that can cause severe dehydration and refuse to go away. Hyperemesis gravidarum might not allow pregnant women to keep any fluids or food down.

Typical symptoms of Hyperemesis gravidarum starts within the first six weeks of pregnancy. HG can be too exhausting, and this can cause weeks or months-long fatigue. 

According to the HER Foundation, women with this condition can experience a total loss of appetite. They might not be able to work or perform their normal daily activities.

HG can cause dehydration and low weight gain during pregnancy. There’s no known way to prevent HG, but there are measures to manage the symptoms.

Symptoms of hyperemesis gravidarum

Hyperemesis gravidarum starts during the first trimester of pregnancy. Although a large number of women experience HG experience symptoms during their entire pregnancy.

HG symptoms include:

  • Feeling nauseated constantly or vomiting more than three times daily
  • Loss of appetite and fatigue
  • Becoming dehydrated
  • Feeling lightheaded or dizzy
  • Losing more than 10 pounds or 5 percent of your body weight due to nausea or vomiting

Causes of hyperemesis gravidarum

Most expecting mothers experienced some degree of morning sickness while pregnant. Although, despite the name, morning sickness isn’t restricted mornings only.

It can occur at any time. Morning sickness and Hyperemesis gravidarum seem to be related to human chorionic gonadotropin (hCG). Hyperemesis gravidarum can be caused by rapidly rising serum levels of hormones like estrogen and HCG (human chorionic gonadotropin).

This hormone is usually created during pregnancy by the placenta. The body produces a large amount of this hormone rapidly early in pregnancy, and these levels can continue to increase throughout the pregnancy.

Extreme nausea and vomiting during pregnancy can sometimes indicate multiple pregnancies (the woman is pregnant with more than one baby) or an abnormal tissue growth that is not a real pregnancy(hydatidiform mole).

This can also be called The trophoblastic disease. The trophoblastic condition happens when there’s an abnormal growth of cells in the uterus.

Risk factors for hyperemesis gravidarum

Some factors can increase the risk of getting HG, and they are:

  • Family history of hyperemesis gravidarum
  • Being pregnant with multiple babies
  • Being a first-time mother
  • Hyperemesis gravidarum during an earlier pregnancy
  • Being overweight
  • Having a multiple pregnancies
  • Being a first-time mother
  • Having trophoblastic disease, which involves the abnormal growth of cells in the uterus

Hyperemesis gravidarum diagnosis

A standard physical exam is typically enough to diagnose most cases. The doctor will ask about medical history and symptoms to analyze if one has HG. Your doctor will look for HG’s common signs, such as abnormally low blood pressure or a fast pulse.

Blood and urine samples can also be taken to check for signs of dehydration. The doctor might also order additional tests to rule out gastrointestinal problems due to your nausea or vomiting.

Ultrasound may be necessary to check if the woman is pregnant with twins or other problems. This test makes use of sound waves to create images of the inside of your body.

Hyperemesis gravidarum treatment

Treatment for HG depends on how severe the symptoms are. The doctor might recommend natural nausea prevention methods, like eating smaller meals and dry foods, such as crackers.

The doctor will also advise you to drink plenty of fluids to stay hydrated. Chronic cases of HG may necessitate hospitalization. Other ways to manage symptoms is by taking; 

Ginger: Taking about 1 to 1.5 grams a day in small doses can help some women. Ginger can be taken in different ways, such as supplements, tea, or lollipops. 

Pyridoxine: This vitamin is also called vitamin B6, and it is often prescribed for pregnant women to relieve nausea. Standard doses are 10 mg to 25 mg, three times daily. Taking more than prescribed can cause temporary nerve damage.

Thiamine. This vitamin (also known as vitamin B1), when taken in doses of 1.5 milligrams daily, can ease vomiting.

Medications: The doctor can prescribe one drug or more drugs to help stop vomiting. The drugs can be taken suppository, IV, in a shot, or orally. Antacids can also help. Another possible treatment is IV steroids. The doctor will make sure any medications he prescribes are safe for the mother and baby. The most commonly prescribed anti-nausea drugs are promethazine and meclizine. Although taking medication while pregnant can cause potential health problems for the baby, but in severe HG cases, maternal dehydration is a more complicated problem. Talk to the doctor about the risks connected with any method of treatment.

Pregnant women who cannot keep fluids or food down due to constant vomiting or nausea will need to be feed through an IV or intravenously. 

  • IV fluids: Doctors will administer electrolytes, saline, and vitamins to keep you hydrated.
  • Tube feeding: If the pregnant woman is still vomiting and cannot keep food down, the doctor might give you nutrition through a tube that goes through the nose and stomach. In severe cases, one may need a tube connected directly to the stomach or small intestine.
  • IV feeding: This bypasses the stomach altogether.

Once the mother isn’t vomiting so much and can hold down food and remain hydrated, you may be able to stop treatments.


Although there are no known ways to prevent hyperemesis gravidarum completely, the following measures might help keep morning sickness from becoming critical:

  • Eating small, frequent meals
  • Eating dry, tasteless, or bland foods
  • Waiting until nausea has improved before taking iron supplements
  • Using a pressure-point wrist band, vitamin B6, and ginger, as recommended by a doctor

What’s the long-term outlook?

The thing to look onto is that symptoms of HG will stop after delivery. However, postpartum recovery can take longer for women with HG.

So consult with your doctor, research, and join support groups to help you and your family deal with HG. Be sure to communicate how you are feeling to your doctor and personal support system.