what is hyperemesis gravidarum

3 min read 08-03-2025

Hyperemesis gravidarum (HG) is a severe form of morning sickness that affects some pregnant people. It's characterized by extreme nausea and vomiting, often leading to significant weight loss, dehydration, and electrolyte imbalances. This condition goes far beyond the typical nausea and vomiting experienced by many pregnant people during the first trimester. Understanding its symptoms, causes, and treatment is crucial for both expecting parents and healthcare professionals.

Symptoms of Hyperemesis Gravidarum

The symptoms of HG are significantly more intense and debilitating than typical morning sickness. They include:

Intense Nausea and Vomiting: This is the hallmark symptom, often occurring throughout the day and night, regardless of food intake. Vomiting can be so severe it leads to exhaustion and inability to keep down fluids or food.
Weight Loss: Significant weight loss is a common sign, often exceeding 5% of pre-pregnancy weight. This is due to the inability to retain food and fluids.
Dehydration: Because of the persistent vomiting, dehydration quickly becomes a serious concern. This can manifest as dry mouth, decreased urination, dizziness, and fatigue.
Electrolyte Imbalances: Prolonged vomiting disrupts the body's electrolyte balance, leading to potential complications such as heart irregularities and seizures.
Ketones in Urine: The body starts breaking down fat for energy due to lack of nutrients, resulting in ketones in the urine. This is a serious sign of starvation.
Acidosis: Severe cases can lead to acidosis, a dangerous condition where the blood becomes too acidic.
Severe Headache: Constant nausea and vomiting can result in persistent, severe headaches.

Causes of Hyperemesis Gravidarum

The exact cause of HG is unknown. However, several factors are thought to contribute:

Hormonal Changes: The rapid surge in hormones during pregnancy, particularly human chorionic gonadotropin (hCG), is believed to play a significant role.
Genetic Predisposition: A family history of HG increases the risk of developing the condition.
Multiple Pregnancy: Pregnant people carrying twins or more are at a higher risk.
Gestational Trophoblastic Disease (GTD): In rare cases, HG can be a symptom of GTD, a group of rare conditions affecting the placenta.
Psychological Factors: While not a direct cause, stress and anxiety can worsen symptoms.

Diagnosis of Hyperemesis Gravidarum

Diagnosis involves assessing the severity and duration of symptoms. A doctor will consider the following:

Medical History: Reviewing the patient's history for family history of HG and other relevant factors.
Physical Examination: Checking for signs of dehydration, weight loss, and electrolyte imbalance.
Blood and Urine Tests: Analyzing blood and urine samples to check electrolyte levels and for the presence of ketones.
Ultrasound: To rule out other conditions, such as GTD.

Treatment for Hyperemesis Gravidarum

Treatment aims to alleviate symptoms, prevent complications, and support both the pregnant person and the developing fetus. Options include:

Dietary Changes: Small, frequent meals; avoiding trigger foods; and consuming bland foods.
Medication: Anti-nausea medications, such as ondansetron (Zofran) and promethazine (Phenergan), are commonly prescribed. Some may require hospitalization for intravenous (IV) fluids and medication.
Fluid and Electrolyte Replacement: Intravenous fluids are often necessary to correct dehydration and electrolyte imbalances.
Vitamin B6 (Pyridoxine): May help reduce nausea and vomiting.
Hospitalization: Severe cases often require hospitalization for close monitoring and treatment.

Living with Hyperemesis Gravidarum

Living with HG can be challenging, both physically and emotionally. Support is crucial:

Seek medical attention immediately: Don't hesitate to seek help if you experience severe symptoms.
Support groups: Connecting with others experiencing HG can provide emotional support and practical advice.
Rest: Prioritize rest to help manage fatigue.
Emotional support: Having a strong support system is essential for managing the physical and emotional toll of HG.

When to Seek Immediate Medical Attention

If you experience any of the following, seek immediate medical attention:

Severe dehydration (extreme thirst, dizziness, lightheadedness)
Inability to keep down any fluids
Excessive weight loss
Signs of electrolyte imbalance (muscle weakness, heart palpitations)
Severe abdominal pain
Fever

Hyperemesis gravidarum is a serious condition that requires prompt medical attention. Early diagnosis and appropriate treatment can help minimize complications and ensure a healthy pregnancy. Remember, you are not alone, and support is available. Don't hesitate to reach out to your healthcare provider if you have concerns.