Hyperemesis Gravidarum: When Morning Sickness Gets Severe

Suffering from severe morning sickness? Here's how to spot the signs of hyperemesis gravidarum and how to treat it safely.
ByChristian Hoffman, MD
May 31, 2017
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Feeling nauseous during pregnancy kinda comes with the territory—experts think anywhere from 50 to 90 percent of women get morning sickness. But when the nausea and vomiting become severe, you’re suddenly dealing with a very different beast. Read on to learn when bad morning sickness is considered hyperemesis gravidarum, what causes it, how common it is and what kind of treatments are available.

What is Hyperemesis Gravidarum?

Just about every pregnant woman knows what it’s like to be nauseated during her nine-month journey (though there are the lucky few who escape morning sickness altogether—go ahead and secretly hate them). But for some women, morning sickness becomes a severe condition that requires medical attention. Hyperemesis gravidarum is defined as extreme, persistent  nausea and vomiting, which can land you in the hospital with dehydration. Symptoms sometimes don’t let up after the first trimester and can stick with you the whole darn pregnancy.

While up to 90 percent of pregnant women develop some level of morning sickness, at least 60,000 cases are severe enough to be considered hyperemesis gravidarum. (Although, since many cases may be unreported, the actual numbers may be even higher.)

What Are the Symptoms of Hyperemesis Gravidarum?

There’s nausea…and then there’s nausea. With hyperemesis gravidarum, the nausea and vomiting are so severe you can become dehydrated and, over time, may even lose some body weight while baby increases his or hers. Other signs of hyperemesis gravidarum include extreme fatigue, fainting, headaches, decrease in urination, low blood pressure and rapid heart rate.

A physical exam (low blood pressure, high pulse rate) can help clue in your doctor as to whether you’ve crossed the line from morning sickness to hyperemesis gravidarum. Your doctor might also run some blood and urine tests to check for signs of dehydration. 

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What Causes Hyperemesis Gravidarum?

There’s some evidence that the severe nausea can be blamed on rising levels of the hormone HCB (human chorionic gonadotropoin), but the exact cause of hyperemesis gravidarum is still unknown. Moms who are pregnant with multiples are at increased risk. If you’re having a molar pregnancy, you may also have these symptoms.

How Will Hyperemesis Gravidarum Affect Baby?

Luckily, while you might feel like hell, chances are baby is continuing to grow without any problems. However, if you don’t get enough nutrition or hydration for a significant amount of time, it can affect baby’s birth weight and development.

How Can You Treat Hyperemesis Gravidarum?

Try modifying your diet to have small, frequent meals (an empty stomach can sometimes trigger more nausea), avoiding fatty foods and drinking plenty of fluids to help prevent dehydration. If that still doesn’t help, your doctor may suggest taking the vitamin B6, which in some cases has been shown to decrease nausea in pregnancy, or even certain anti-nausea prescription medications.

Unfortunately, there’s not much, if anything, you can do to prevent hyperemesis gravidarum. But the good news is that while it’s sheer misery when you’re in the midst of it, this is one condition that definitely goes away the moment baby is born.

Hyperemesis Gravidarum Stories From Other Pregnant Moms

“I had this with my first, and it was significantly worse with my second. I was hospitalized and on home health care with IVs and a Zofran pump for several months. We are currently trying to conceive our third, and I am terrified of going through it again.”

“I have had it both pregnancies, but mine was and still is manageable. They almost sent me home with an IV about 12 weeks or so, but things got better, so I didn’t end up going that route. I have a friend that was so bad she needed the IV and nurse care at home for quite some time.”

“I was on three different medications that I injected into my IV line that I had all the time. I had a backpack IV bag so I could leave the house with my IV pole. Unfortunately, there wasn’t that much that helped me and I was sick until I delivered.”

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