Hyperemesis Gravidarum

Upset stomach (nausea) and vomiting are common in pregnancy. It is often called morning sickness. But it can happen at any time of day. Severe nausea and vomiting that doesn’t let up is not normal. This is known as hyperemesis gravidarum. It may develop around the 5th week and last until the 16th week of pregnancy. In some women, it may last longer. It can cause too much fluid loss (dehydration). And it can cause weight loss. This can be dangerous for the mother and baby. 

Morning sickness may be caused by an increase in some hormone levels. It is not clear why it’s more severe in some people. It may be more likely if you are carrying twins or more. You may need some tests. These are to check for other health conditions that can cause severe nausea and vomiting.

The focus of treatment for severe morning sickness is to:

  • Ease your symptoms

  • Prevent weight loss

  • Prevent too much fluid loss (dehydration)

Follow the advice below carefully. If your symptoms don't get better with home care, you may need to stay in the hospital. In the hospital, you may get IV (intravenous) fluids and medicines. In very severe cases, you may need more time in the hospital. You may need IV nutrition or tube feeding. If you need these, your healthcare provider will tell you more.

Home care

Diet

  • Keep a list of the foods you eat and how they affect your symptoms. Don't eat foods that trigger your symptoms.

  • Eat small meals often rather than 3 large meals. This can help keep your stomach from being empty. An empty stomach can make nausea worse.

  • Choose foods that are high in carbohydrates. Eating foods high in protein may also help. Limit greasy or spicy foods.

  • Before getting out of bed in the morning, try eating crackers or dry toast. This may help settle your stomach.

  • Drink cold, clear liquids. Drink small amounts of liquids with electrolytes, such as sports drinks.

Medicine

If needed, your healthcare provider may prescribe medicines to help ease nausea and vomiting. Your provider may suggest vitamin B6 and ginger. Don’t use any over-the-counter medicines or home remedies without talking with your provider first.

Follow-up care

Follow up with your healthcare provider as advised.

When to get medical care

Call your healthcare provider right away if you have any of these:

  • Dry mouth and extreme thirst

  • Dark urine or small amounts of urine

  • Dizziness, weakness, or fainting

  • Vomiting that won’t stop

  • Inability to keep down liquids

  • Frequent diarrhea

  • Weight loss or no weight gain over a 2-week period

  • Severe constant pain in the lower right abdomen

  • Fever of 100.4°F (38°C) or higher, or as advised

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