Hyperemesis Gravidarum

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WHAT IS HYPEREMESIS GRAVIDARUM? (ICD CODE 0211) Hyperemesis gravidarum (HG) is the most severe form of nausea and vomiting in pregnancy. The joy of most women is pregnancy, but the challenges of pregnancy are much. Many pregnant women have morning sickness. But for a few, it is much more severe. Fewer than 3% of pregnant women […] Read More

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Hyperemesis Gravidarum

WHAT IS HYPEREMESIS GRAVIDARUM? (ICD CODE 0211) Hyperemesis gravidarum (HG) is the most severe form of nausea and vomiting in pregnancy. The joy of most women is pregnancy, but the challenges of pregnancy are much. Many pregnant women have morning sickness. But for a few, it is much more severe. Fewer than 3% of pregnant women suffer from a temporal health condition called hyperemesis gravidarum.Hyperemesis gravidarum is a temporary disorder. There is no cure for hyperemesis gravidarum, however, it can be managed.  Hyperemesis gravidarum is derived from:
  • Hyper = over, excessive, above.
  • Emesis = act of vomiting.
  • Gravid = pregnant woman.
  • Rum = odd person.
Therefore, this means “hyperemesis” (excessive vomiting) “gravidarum” (odd pregnant woman). When a pregnant woman has hyperemesis gravidarum, she vomits a lot, sometimes almost constantly. This situation can lead to a lot of problems, such as dehydration (loss of body fluid) and weight loss. It is commonly wrongly referred to as morning sickness, but it is not that.  Hyperemesis Gravidarum vs. Morning Sickness Morning sickness typically fades away by the end of the first trimester. However, hyperemesis gravidarum is a more severe kind of morning sickness and may last beyond the end of the first trimester.  It is effective between the 4th and 6th week of pregnancy. It worsens around the 9th and 13th week. During this period, vomiting becomes so severe that most women cannot even engage in their typical daily activities.  By week 20, the symptoms usually get better in some women. HYPEREMESIS GRAVIDARUM RISK FACTORS Some factors seem to contribute to your chances of having HG. The risk factors of hyperemesis gravidarum include:
  • Family history.
  • Obesity.
  • Pregnancy with more than one baby.
  • First-time pregnancy.
  • Trophoblastic disease (abnormal cell growth inside the uterus).
RISKS OF HYPEREMESIS GRAVIDARUM The main risks of hyperemesis gravidarum are:
  • Weight loss.
  • Dehydration.
  • Electrolyte imbalance.
  • Life-threatening risks such as death.
  • Pre-term labor (premature delivery).
  • Preeclampsia (sudden development of high blood pressure during pregnancy).
HYPEREMESIS GRAVIDARUM COMPLICATIONS The complications that may arise as a result of hyperemesis gravidarum may include:
  • Marked psychological burden.
  • Electrolyte imbalance.
  • Nutritional deficiencies.
  • Wernicke’s encephalopathy.
  • Thrombosis.
  • Esophageal trauma.
  • Cerebral vascular spasm.
  • Pre-term labor.
  • Recurrence in subsequent pregnancies.
  • Offspring may suffer:
    • Long-term high serum cortisol.
    • Decreasing insulin sensitivity.
    • High-risk of mood.
    • Psychiatric problems.
  • Toxemia, a serious threat to the pregnancy.
HYPEREMESIS GRAVIDARUM DIAGNOSIS Hyperemesis gravidarum may be diagnosed by:
  • A thorough clinical evaluation.
  • Detailed patient’s medical history.
  • Patient’s family history.
  • Identification of symptoms.
  • An ultrasound, to find out if you are pregnant with twins or more babies.
HYPEREMESIS GRAVIDARUM TREATMENT The specialty for the treatment of hyperemesis gravidarum is gynecology. Any treatment for hyperemesis gravidarum depends on the severity of your symptoms. You can perform most of the guidelines for hyperemesis gravidarum treatment at home. Possible treatment lines may include:
  • Preventive Measures.
These might include the use of:
    • Ginger.
    • Vitamin B6.
    • Acupressure-point wristband (similar to those for motion sickness).
  • Meals’ Adjustment.
Eat small quantities of food at frequent times. Dry foods such as crackers can be helpful. You can follow a strict hyperemesis gravidarum diet plan as recommended by your dietician.
  • Intravenous Fluids.
Maintain your fluid intake with intravenous (IV) fluids. In severe cases, hospitalization is necessary. When you can take in fluids by mouth, IV fluids may be discontinued.
  • Total Prenatal Nutrition (TPN).
In most severe cases of HG, complex, balanced solutions of nutrients should be administered through an IV throughput pregnancy.
  • Medications.
When nausea and persistent vomiting pose great risks to the mother and child, medicines should be administered. Hyperemesis gravidarum medications can be given intravenously if the patient cannot take them through the mouth. Also, suppository medicines can be used. Some medications for hyperemesis gravidarum and used to prevent nausea include:
  1. Promethazine (Avomine 25mg), one tablet, four times daily.
  2. Meclizine.
  3. Droperidol.
  4. Cyclizine 50mg, three times daily.
  5. Domperidone.
  6. Prochlorperazine (Stemetil 10mg), 3 times daily.
  7. Ondansetron, having an oro-dispersal (melting on the tongue) version, easier for women to manage.
HYPEREMESIS GRAVIDARUM PREVENTION The following home-used measures might help keep hyperemesis gravidarum from becoming severe:
  • Little frequent meals.
  • Bland foods.
Your food should be blended, and a balanced diet with all nutrients complete.
  • Wait until the nausea has improved before taking your iron supplements.
  • Use an acupressure-point wristband.
Motion sickness wristbands and bracelets use the acupressure principle.
  • Drink smaller drinks, but drink more often and use a straw.
  • Try cold foods, if hot ones trigger nausea.
  • Take ginger (1─15 grams) daily, in several small doses.
You can take it in tea, lollipops, or supplements. It can be purchased in medicine stores.
  • Take pyridoxine (vitamin B6) 10mg to 25mg, thrice a day.
Excessive intake of vitamin B6 leads to temporary nerve damage. It can also be purchased in medicine stores as well.
  • Take thiamine (vitamin B1), 1.5mg, once a day; available over-the-counter (in medicine stores).
HYPEREMESIS GRAVIDARUM PROGNOSIS Hyperemesis gravidarum always occurs during first pregnancies, and usually recurs in subsequent pregnancies, characterized by severe nausea, vomiting, and spitting. Although there is no cure for hyperemesis gravidarum, treatment can reduce the severity of the symptoms and prevent serious complications. Hyperemesis gravidarum is only a temporary condition.



Some of the common signs and symptoms of hyperemesis gravidarum include:

  • Feeling nausea, almost constantly.
  • Loss of appetite.
  • Severe vomiting almost every time.
  • Dehydration.
  • Dizziness or light-headedness.
  • Loss of about 5% body weight.
  • Increased salivation.



The causes of hyperemesis gravidarum are beyond the understanding of medical professionals, but it is thought to be related to a rise in hormone human chorionic gonadotropin (hCG) levels, created by the placenta during pregnancy. 

Women who suffered hyperemesis gravidarum during their first pregnancy have a higher chance of getting it again in their next pregnancy. There is also no known way to prevent its occurrence, though taking multivitamins before getting pregnant is said to be have been of little help.


Who is the most affected by hyperemesis gravidarum?

Hyperemesis gravidarum is an experience of some pregnant women, which some call morning sickness, though it is not. It has a lot of complications that could be life-threatening to both the mother and child.

Is hyperemesis gravidarum considered high-risk pregnancy?

Hyperemesis gravidarum is considered a high-risk pregnancy, known to increase the risk of preeclampsia, stillbirth, and premature birth, especially in most severe cases.

What are the long-term effects of hyperemesis gravidarum?

Hyperemesis gravidarum causes weight loss, malnutrition, dehydration, and debility, due to severe nausea and/or vomiting, causing long-term health issues for the mother and child.

How long does hyperemesis gravidarum last?

Hyperemesis gravidarum usually lasts 12─14 weeks; beginning around the 6th week of pregnancy, peaking around the 9th week, and disappearing around the 16th or 20th weeks. Although unpleasant, morning sickness is a normal sign of pregnancy.

Can hyperemesis gravidarum cause birth defects?

Hyperemesis gravidarum causes birth defects such as low birth weight, premature delivery, small-for-gestational-age (SGA), and prenatal death (in extreme c