Hyperemesis gravidarum is extremely severe nausea and excessive vomiting during pregnancy.

Hyperemesis gravidarum differs from ordinary morning sickness. If women vomit often and have nausea to such an extent that they lose weight and become dehydrated, they have hyperemesis gravidarum. If women vomit occasionally but gain weight and are not dehydrated, they do not have hyperemesis gravidarum. The cause of hyperemesis gravidarum is unknown.

Diagnosis and Treatment

Doctors do blood and urine tests to determine whether dehydration is present and to check for electrolyte abnormalities, which may result from dehydration.

If hyperemesis gravidarum is confirmed, the woman is sometimes hospitalized for treatment because vomiting may persist for days. She is given fluids, sugar (glucose), electrolytes, and occasionally vitamins through an intravenous line inserted into a vein. She is not allowed to eat or drink anything for at least 24 hours. Sedatives, drugs used to relieve nausea (antiemetics), and other drugs are given as needed. After the woman is rehydrated and vomiting has subsided, she is given fluids to drink. If she can tolerate fluids, she can begin eating frequent, small portions of bland foods. The size of the portions is increased as she can tolerate more food.

If symptoms recur, the treatment is repeated. Rarely, if weight loss continues and symptoms persist despite treatment, the woman is fed via a tube passed through the nose and down the throat to the small intestine for as long as necessary.

Last full review/revision December 2008 by Edmund F. Funai, MD