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A.D.A.M. Medical Encyclopedia.

Hyperemesis gravidarum

Nausea - persistent - in pregnancy; Vomiting - persistent - in pregnancy

Last reviewed: November 8, 2012.

Hyperemesis gravidarum is extreme, persistent nausea and vomiting during pregnancy that can lead to dehydration.

Causes, incidence, and risk factors

Nearly all women have some nausea or vomiting (morning sickness), particularly during the first 3 months of pregnancy. The cause of nausea and vomiting during pregnancy is believed to be a rapidly rising blood level of a hormone called human chorionic gonadotropin (HCG). HCG is released by the placenta.

Extreme nausea and vomiting during pregnancy can happen if you are pregnant with twins (or more babies) or if you have a hydatidiform mole.

Symptoms

Signs and tests

The doctor will do a physical exam. Blood pressure may be low. Pulse may be high.

The following laboratory tests will be done to check for signs of dehydration:

Your doctor may need to run tests to make sure you do not have liver and gastrointestinal problems.

A pregnancy ultrasound will be done to see if you are carrying twins or more babies. Ultrasound also checks for a hydatidiform mole.

Treatment

Small, frequent meals and eating dry foods such as crackers may help relieve uncomplicated nausea.

Drink plenty of fluids. Increase fluids during times of the day when you feel least nauseated. Seltzer, ginger ale, or other sparkling waters may be helpful.

Vitamin B6 (no more than 100 mg daily) has been shown to decrease nausea in early pregnancy. Ask your health care provider if this vitamin might help you.

If your nausea and vomiting is so severe that you and your baby might be in danger, your doctor will prescribe anti-nausea medicine. If your case is very severe, you will likely be admitted to the hospital. There, fluids will be given to you through an IV.

Expectations (prognosis)

Nausea and vomiting is usually worst between 2 and 12 weeks of pregnancy and goes away by the second half of pregnancy. Sometimes it will last longer. With proper identification of symptoms and careful follow-up, serious complications for the baby or mother are rare.

Complications

Too much vomiting is harmful because it leads to dehydration and poor weight gain during pregnancy.

Social or psychological problems may be associated with this disorder of pregnancy. If these problems exist, they need to be identified and taken care of by the health care provider.

Calling your health care provider

Call your health care provider if you are pregnant and have severe nausea and vomiting.

References

  1. Cappell MS. Hepatic and gastrointestinal diseases. In: Gabbe SG, Niebyl JR, Simpson JL. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 45.
  2. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2003;(4):CD000145. [PubMed: 14583914]

Review Date: 11/8/2012.

Reviewed by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Interventions for nausea and vomiting in early pregnancyInterventions for nausea and vomiting in early pregnancy
    Nausea, retching or dry heaving, and vomiting in early pregnancy are very common and can be very distressing for women. Many treatments are available to women with 'morning sickness', including drugs and complementary and alternative therapies. Because of concerns that taking medications may adversely affect the development of the fetus, this review aimed to examine if these treatments have been found to be effective and safe.
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