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Hyperemesis Gravidarum: Not Just a Case of Morning Sickness

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics

Written by Nikita Bhalla · Updated Feb 05, 2023

Hyperemesis Gravidarum: Not Just a Case of Morning Sickness

Pregnancy often comes coupled with acute nausea and constant vomiting. However, while most symptoms are manageable, some are also worrisome and need further medical assistance. Hyperemesis gravidarum is one of them. What is it?

Hyperemesis gravidarum is different from morning sickness and it is imperative to know the uniqueness of each condition, especially as the former should not be overlooked. 

What Is Hyperemesis Gravidarum?

Hyperemesis gravidarum is a condition wherein the normal morning sickness in pregnancy does not apply. By normal standards, when it comes to morning sickness, nausea goes away in about 12 weeks. However, when a person is suffering from hyperemesis gravidarum, there is severe vomiting in pregnancy. This is not good, especially in the case of pregnant women who should retain maximum nutrition.

Another major difference to note between morning sickness in pregnancy and hyperemesis gravidarum is in the case of the former. After 12 weeks, those with morning experience may experience a minor change or loss of appetite, which is normal. On the other hand, in the case of the latter, there is a complete loss of appetite. This leads to drastic weight loss or gain and dehydration, which is especially not good during pregnancy.

Symptoms of Hyperemesis Gravidarum

This condition usually starts in the first trimester of the pregnancy, coupled with the following warning symptoms. Given most of these look like normal pregnancy issues, they can be mistaken for morning sickness. The key is to pay attention to its severity.

  • Severe vomiting induced by acute nausea
  • Anemia
  • Headache
  • Increased level of saliva secretion
  • Excessive dizziness and fainting
  • Yellowing of eyes and skin, a sign of oncoming jaundice
  • Low blood pressure
  • A constant state of confusion

Also note that if the frequency of vomits is more than four times a day, there is something definitely wrong. Excessive vomiting which leads to dizziness and dehydration should be looked into. Also, keep a tab on the weight. A weight loss of more than 5 kg in a month is alarming and not a symptom of a healthy pregnancy.


To put it simply, the following are the causes behind the condition:

  • Multiple pregnancies such as twins, triplets, etc.
  • When the contents of the upper small intestine regurgitate back to the stomach
  • Hydatidiform mole, i.e. a condition wherein the uterus houses an abnormal tissue growth inside it
  • An abnormal peristalsis process, which means there is a defect in the way the stomach moves the contents around
  • Increasing hormonal levels
  • Rising blood thyroxine levels
  • Abnormalities in the functioning of the liver
  • Zinc and pyridoxine deficiency
  • Helicobacter pylori infection which causes stomach ulcers
  • Problems in the inner part of the ear

It has to be noted that there are no yet proven direct causes of hyperemesis gravidarum. However, the aforementioned list, even if not exhaustive, gives a fair idea of the causes of the condition.

Risk Factors and Complications

While we have mentioned the causes behind the condition, it is imperative to specifically know the risk factors too. The following are the women who are more at risk of getting hyperemesis gravidarum:

  • Ones who are carrying multiple pregnancy to full term
  • First-time mothers
  • The ones who are suffering from a trophoblastic disease
  • Overweight mothers
  • The ones who have suffered from the condition during an earlier pregnancy
  • The ones who have a genetic history of the condition

The aforementioned are especially at the risk of getting hyperemesis gravidarum and need to be monitored for the same.

Hyperemesis gravidarum should not be left on its own. It’s important it gets treated or there are multiple risks that the mother and the unborn child may face. Here are a few complications that arise due to the condition. Some of them may have lasting implications.

  • Collapsed lung
  • Liver disease
  • Blindness
  • Rupturing of the esophagus due to excessive vomiting
  • Seizures
  • Blood clot formation
  • Kidney failure
  • Coma
  • Death

This condition, if not treated, can be fatal for both the mother and child. It is essential to keep tabs and get it treated.

Diagnosis of Hyperemesis Gravidarum

Mostly, the doctor will ask routine questions about medical and genetic history along with checking your symptoms. A usual physical examination follows. The doctor may look for signs of dehydration, abnormally fast pulse, or lower blood pressure. Blood and urine samples may also be taken to check complete blood count, electrolytes levels, and urine ketones to confirm the diagnosis or rule out other conditions. In case you are undergoing multiple pregnancy, an ultrasound may also be required.


Severe symptoms may require hospitalization. However, milder cases can be treated at home. Some of the most popular management recommendations are:

  • Intravenous or IV fluids to counter the dehydration.
  • Pressure-point wristbands or ginger or peppermint to counter excessive nausea.
  • In case of extremely severe cases, parenteral nutrition is supplied via an IV solution.
  • Complementary therapies such as acupuncture, hypnosis, and massage may be tried if allowed by the doctor.
  • If the vomiting and nausea do not cease using preventive measures, your doctor may prescribe certain medicines (that are safe for the pregnancy).
  • Instead of heavy meals, consume small and frequent meals with some tasteless snacks in between to combat the enhanced senses.

Please note that these vary from patient to patient depending on the severity of the case and the risk factors involved. In any case, do not self-treat. Instead always consult a medical professional.

The condition usually goes away after delivery. However, the postpartum recovery of women who have suffered from it will be slightly longer than the ones who did not. In addition, if not treated, it may even turn fatal during the term or by the end of it.

The best way to combat hyperemesis gravidarum is to be aware of the growing intensity of your symptoms. As soon as you feel they are getting worse, let your doctor know. 

Learn more about Pregnancy Problems here


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Regina Victoria Boyles, MD


Written by Nikita Bhalla · Updated Feb 05, 2023

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