But sometimes the symptoms are so extreme — severe, persistent nausea, vomiting, and weight loss during pregnancy — that it may be diagnosed as a less common disorder known as hyperemesis gravidarum.
Signs and Symptoms of Hyperemesis Gravidarum
- Feeling dizzy, lightheaded, and faint
- Losing more than 5 percent of body weight
- Becoming dehydrated, with signs of dehydration such as dark urine and dry skin
- Electrolyte and nutritional imbalances
- Increased salivation
- Rapid heart rate
- Low blood pressure
- Yellowing of the skin and eyes (jaundice)
- Depression and anxiety
Causes and Risk Factors of Hyperemesis Gravidarum
Other associations include:
- Increase in blood levels of thyroxine (a growth-regulating hormone produced by the thyroid), which has been documented in up to 73 percent of hyperemesis gravidarum cases, according to the HER Foundation
- Abnormal tissue growth in the uterus, called a molar pregnancy
The following factors may increase your chances of getting hyperemesis gravidarum:
- Having the condition during a previous pregnancy
- Other women in your family developed the condition
- Multiple pregnancy
- First-time pregnancy
- Younger maternal age; risk may decrease after age 35
How Is Hyperemesis Gravidarum Diagnosed?
Your doctor will perform a physical exam and order the following lab tests to assess signs of dehydration.
- A complete blood count
- A serum electrolyte test (blood test)
- Ketones urine test (when the body isn't getting enough nutrients, it begins to break down fat, which leads to an increase in waste products known as ketones)
Prognosis of Hyperemesis Gravidarum
Duration of Hyperemesis Gravidarum
Treatment and Medication Options for Hyperemesis Gravidarum
For less severe cases, you may be able to seek treatment at home or at a doctor's office.
While the course of treatment for hyperemesis gravidarum varies from person to person, your doctor may recommend one or more of the following:
- Vitamin B6
- Small, frequent meals that include dry, bland foods such as crackers
- Intravenous fluids to help with dehydration
- For severe cases, parenteral nutrition, in which an intravenous (IV) solution of vitamins and nutrients is given as a substitute for food
Alternative and Complementary Therapies
- Acupuncture and acupressure
- Light therapy (to help with depression)
Prevention of Hyperemesis Gravidarum
Complications of Hyperemesis Gravidarum
In addition, there’s a potential for babies to be born at a low weight.
Rare but severe complications of hyperemesis gravidarum can be life-threatening and include:
- Esophageal damage from forceful vomiting
- Liver disease
- Blood clots
Research and Statistics: Who Gets Hyperemesis Gravidarum?
Related Conditions of Hyperemesis Gravidarum
A number of gastrointestinal conditions can cause symptoms similar to hyperemesis gravidarum and may need to be ruled out during diagnosis. These include:
And the following conditions can also have similar symptoms:
- Inflammation of the kidneys and pelvis (pyelonephritis)
- Degeneration of abnormal growths of fibrous tissue (fibroid degeneration)
- Twisting of the ovary (ovarian torsion)
Resources We Love
This nonprofit organization is devoted to supporting and educating women who are experiencing hyperemesis gravidarum or have gone through it in the past. HER offers comprehensive info on what the condition is, how to manage it physically and emotionally, and the latest research. Different sections for pregnant women as well as their friends and family target and address a range of needs.
NORD works with individual patients and organizations to bring awareness to rare disorders. In addition to a highly informative, up-to-date page on hyperemesis gravidarum, this nonprofit also has a resource center for patients and caregivers.
The BMJ (British Medical Journal) podcasts focus on a variety of health issues. The episode on hyperemesis gravidarum, "The Bone-Crushing Nausea of Hyperemesis," features of panel of experts — women who have had hyperemesis gravidarum themselves and also research or treat it — discussing what the condition is like and how to manage it.
UCLA Health partnered with the HER Foundation on this free iOS app for women experiencing hyperemesis gravidarum. It tracks how little (or how much) you've eaten and whether your treatments are working, sends alerts if your weight drops or you're getting dehydrated and need medical attention, reminds you to take meds, and more.
Editorial Sources and Fact-Checking
- Hyperemesis Gravidarum. National Organization for Rare Disorders (NORD). 2020.
- About Hyperemesis Gravidarum: Assess and Diagnose. HER Foundation.
- Is an HG Pregnancy High Risk? HER Foundation.
- Hyperemesis Gravidarum (Severe Nausea and Vomiting During Pregnancy). Cleveland Clinic. November 4, 2016.
- Hyperemesis Gravidarum. MedlinePlus. November 23, 2020.
- Fejzo M, Sazonova O, Sathirapongsasuti JF, Hallgímmsdottír, et al. Placenta and Appetite Genes?GDF15?and?IGFBP7?Are Associated With Hyperemesis Gravidarum. Nature Communications. March 21, 2018.
- Jennings L, Krywko D. Hyperemesis Gravidarum. StatPearls. November 21, 2020.
- Explaining the Cruel Injustice of Morning Sickness. Cleveland Clinic. June 26, 2020.
- About Hyperemesis Gravidarum: Causes. HER Foundation.
- Hyperemesis Gravidarum. Merck Manual Consumer Version. October 2020.
- Hyperemesis Gravidarum. Merck Manual Professional Version. October 2020.
- Nausea and Vomiting of Pregnancy: Treatment and Outcome. UpToDate. October 2020.
- Ginger for Morning Sickness. Michigan Medicine. May 29, 2019.
- About Hyperemesis Gravidarum: Complementary Therapies. HER Foundation.
- Farid H. Hyperemesis: (Way) Beyond Morning Sickness.?Harvard Health Publishing. July 9, 2019.
- Hyperemesis Gravidarum (Severe Nausea and Vomiting During Pregnancy): Prevention. Cleveland Clinic. November 4, 2016.
- About HG for Mothers. HER Foundation.
- Wernicke-Korsakoff Syndrome. MedlinePlus. November 23, 2020.
- Morning Sickness. March of Dimes. September 2017.
- Is Psychiatric Illness a Risk Factor for Hyperemesis Gravidarum??Massachusetts General Hospital Center for Women’s Mental Health. July 13, 2017.