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What is Hyperemesis Gravidarum & How is it Treated?|Difference Between Morning Sickness and Hyperemesis Gravidarum?

Pregnancy is one of the happiest times in a woman’s life. While pregnancy comes with its own set of side effects and discomforts, perhaps none is as unbearable as hyperemesis gravidarum. Many may recognize this condition as the one that the Duchess of Cambridge, Kate Middleton, suffered from during her pregnancies. Hyperemesis gravidarum is a condition that is characterized by severe nausea and vomiting during pregnancy. While every woman suffers from some form of morning sickness particularly during the first three months of pregnancy, women who experience hyperemesis gravidarum have it much worse. While it is only a temporary condition, there is still no cure for it and you only have to find ways to manage it. Nearly three percent of pregnant women get diagnosed with this condition. Let’s find out more about what exactly is hyperemesis gravidarum and what you can do about it.

What is Hyperemesis Gravidarum?

Hyperemesis gravidarum is a condition that affects pregnant women. It is marked by severe nausea and vomiting, and could also lead to weight loss as well as a disturbance in the body’s electrolyte levels. While mild cases of hyperemesis gravidarum are treated with rest, antacids, and dietary changes, more severe cases may require the patient to be hospitalized in order to receive fluids and nutrition intravenously. It is important that you do not take any medication for solving this condition without consulting your doctor first.

What is Hyperemesis Gravidarum

Many women often get confused about how hyperemesis gravidarum differs from the normal morning sickness, which is a common occurrence in pregnancy, especially in the first 12 weeks or first three months of the pregnancy. It is important to understand the difference between morning sickness and hyperemesis gravidarum so that your condition can be treated properly.

Difference Between Morning Sickness and Hyperemesis Gravidarum

Morning sickness marks the start of the first month of the pregnancy and tends to go away by the end of the third month or by the start of the fourth month. Pregnant women who experience morning sickness will feel fatigued and may also experience a slight loss of appetite. They may also have difficulty performing their daily chores due to the tiredness that sets in.

Hyperemesis gravidarum, on the other hand, is characterized by nausea that refuses to go away and it is generally followed by severe vomiting that can even cause severe dehydration. This condition does not allow the mother to keep anything down, be it solid food or fluids. This is why the risk of dehydration increases if you suffer from hyperemesis gravidarum.

The symptoms of hyperemesis gravidarum start during the first six weeks of becoming pregnant, and nausea sometimes may last throughout the entire pregnancy itself. This condition causes the woman to experience severe fatigue that can last even for months or several weeks. Women who experience hyperemesis gravidarum are generally unable to perform any of their day-today-activities and are generally unable to go to work as well. They will also experience a total loss of appetite.

Due to this, the condition of hyperemesis gravidarum can result in weight loss and dehydration during pregnancy. It also makes it hard for the mother to put on any pregnancy weight.

There is no known method of stopping hyperemesis gravidarum or morning sickness, except for learning to manage the symptoms over a period of time.

Symptoms of Hyperemesis Gravidarum

The condition of hyperemesis gravidarum starts during the first three months of the first trimester of pregnancy. Nearly half of the women suffering from hyperemesis gravidarum experience its symptoms during their entire pregnancy and some experience a relief from symptoms after the third or fourth month.

Common symptoms of hyperemesis gravidarum include:

  • Feeling constant nausea almost all the time
  • Severe vomiting that happens more than 3 or 4 times a day
  • Loss of appetite
  • Dehydration
  • Feeling dizzy or light-headed
  • Losing more than five percent or 10 pounds of body weight due to vomiting
  • Food aversions
  • Headaches
  • Confusion
  • Jaundice
  • Low blood pressure
  • Loss of skin elasticity
  • Increase in heart rate
  • Extreme fatigue
  • Secondary depression or anxiety

Producing excess saliva, causing you to swallow constantly, which may make your nausea even worse

You may experience low levels of minerals or electrolytes including potassium, sodium, and others. This may cause your blood pressure to drop and make you feel weak.

In extreme cases, your kidneys may also stop functioning properly, making you urinate less than normal.

What Causes Hyperemesis Gravidarum?

It is common for most women to experience some level of morning sickness once they become pregnant. Normal morning sickness involves some level of nausea and vomiting during the period of pregnancy. However, just because it is called morning sickness, this does not mean that nausea and vomiting will only occur during the morning. Morning sickness can affect you at any time of the day.

The exact cause of hyperemesis gravidarum and morning sickness remains unknown but it is believed to have a connection to hCG or human chorionic gonadotropin hormone. hCG is a hormone that is produced by the placenta during pregnancy. The woman’s body starts producing a large amount of hCG during pregnancy and that too at a rapid rate. Furthermore, the levels of hCG hormone keep on increasing throughout the pregnancy.

Risk Factors for Hyperemesis Gravidarum

There are certain risk factors which increase your risk of getting hyperemesis gravidarum. These include:

  • Being pregnant with multiple babies
  • Being overweight
  • Having a family history of hyperemesis gravidarum
  • Being pregnant for the first time

There are also certain conditions that increase the risk of getting hyperemesis gravidarum including trophoblastic disease, which occurs when there is an abnormal cell growth inside the uterus.

Diagnosis of Hyperemesis Gravidarum

If you are suffering from bouts of morning sickness that are worse than usual, then you must inform your doctor about the same. Your doctor will take down your detailed history and also inquire about your symptoms. Generally, a standard physical examination is enough for diagnosing hyperemesis gravidarum. Your doctor will also check for certain common symptoms of this condition, particularly low blood pressure along with a fast pulse rate.

You will also be advised to provide blood and urine samples to look for potential signs of dehydration. If your doctor suspects any gastrointestinal problems as the cause of your vomiting and nausea, then he/she may also recommend some additional tests to rule out gastrointestinal issues.

If you are pregnant with multiples, then your doctor may also find it necessary to order an ultrasound, just to check that everything is alright with the babies.

Treatment of Hyperemesis Gravidarum

Hyperemesis gravidarum is treated based on the severity of your symptoms and your overall health. To begin with, your doctor may recommend that you start taking some natural remedies for nausea prevention, such as ginger or vitamin B6.

You should also have smaller meals but eat more frequently. In between the meals, you can try munching on some dry foods such as crackers and stay hydrated by drinking plenty of fluids.

If your condition is severe, then you may require to be hospitalized. During pregnancy, if you are unable to keep down any food and fluids and are vomiting frequently, then you will need to be hospitalized so that you can be given nutrition and fluids intravenously, through an IV.

During cases of frequent vomiting, your doctor may prescribe some medication. Some of the most commonly used anti-nausea medications include meclizine and promethazine. Thiamine, a vitamin called B1, is also prescribed sometimes to help ease the vomiting. You can also receive these medications through an IV.

Do not self-medicate while you are pregnant. It can cause many types of complications for your baby. However, when your condition becomes severe, then your doctor will weigh the risks associated with any other treatment method against giving medications. You will only be prescribed medications that are safe to have while being pregnant.
Outlook for Hyperemesis Gravidarum

It can be difficult to manage hyperemesis gravidarum. While hyperemesis gravidarum will disappear on its own after you deliver the baby, having this condition may mean that your postpartum recovery period could be a bit longer. In order to keep yourself and your baby healthy throughout the pregnancy, it is important that you consult your doctor and discuss your symptoms so that the best possible treatment plan can be worked out keeping in mind the safety of your baby.


  1. Fischer-Rasmussen, W., Kjær, S.K., Dahl, C. and Asping, U., 1991. Ginger treatment of hyperemesis gravidarum. European Journal of Obstetrics & Gynecology, 38(1), pp.19-24.
  2. Eliakim, R., Abulafia, O. and Sherer, D.M., 2000. Hyperemesis gravidarum: a current review. American Journal of Perinatology, 17(04), pp.207-218.
  3. Goodwin, T.M., Montoro, M.A.R.T.I.N., Mestman, J.H., Pekary, A.E. and Hershman, J.M., 1992. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. The Journal of Clinical Endocrinology & Metabolism, 75(5), pp.1333-1337.
  4. Abell, T.L. and Riely, C.A., 1992. Hyperemesis gravidarum. Gastroenterology Clinics of North America, 21(4), pp.835-849.
  5. Verberg, M.F.G., Gillott, D.J., Al-Fardan, N. and Grudzinskas, J.G., 2005. Hyperemesis gravidarum, a literature review. Human reproduction update, 11(5), pp.527-539.
  6. Dodds, L., Fell, D.B., Joseph, K.S., Allen, V.M. and Butler, B., 2006. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstetrics & Gynecology, 107(2), pp.285-292.
  7. Fell, D.B., Dodds, L., Joseph, K.S., Allen, V.M. and Butler, B., 2006. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstetrics & Gynecology, 107(2), pp.277-284.
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 8, 2021

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