Hyperemesis Gravidarum – More Than Morning Sickness

Hyperemesis Gravidarum - More Than Morning Sickness

Hyperemesis Gravidarum

Morning sickness is one of the earliest signs of pregnancy — almost a rite of passage into this new stage of your life.

Sometimes morning sickness lasts all day, and sometimes it doesn’t happen in the morning at all but the afternoon or evening.

For some women, though, morning sickness becomes extreme — the nausea and vomiting of pregnancy may keep her from getting the nutrition she needs.

Called Hyperemesis Gravidarum (HG), this illness in some cases can lead to dehydration, metabolic disruption, and weight loss for the mother-to-be, as well as growth restriction or preterm birth for baby, among other complications.

While not every mother will experience the worst difficulties, all moms with Hyperemesis Gravidarum need treatment and support.

Hyperemesis Gravidarum is characterised as severe nausea and vomiting associated with pregnancy that results in weight loss and metabolic issues. Women with Hyperemesis Gravidarum experience disruptions in hydration and proper nutrition, and may lose 5%-10% of their pre-pregnancy body weight.

In severe cases, hospitalisation with intravenous hydration and nutrition is needed. Hyperemesis Gravidarum is extremely debilitating and interferes with your normal daily routine. It typically begins very early in pregnancy and continues to 21 weeks or longer.

What Causes Hyperemesis Gravidarum?

Researchers don’t know the exact cause of Hyperemesis Gravidarum, but they do have some theories. One belief is that the sudden changes in hCG, oestrogen and progesterone in early pregnancy disturb the balance of hormones for some women.

Other researchers have explored the relationship between Hyperemesis Gravidarum and thyroid hormones, since many women with this illness have elevated thyroxine levels. Another thought is that the same hormones that support pregnancy slow digestions as well. As a result, the gastrointestinal muscles may be slack enough that they cause regurgitation and related nausea and vomiting.

An unlikely theory that persists is that Hyperemesis Gravidarum is related to a woman’s mental state — but most researchers agree that the psychological changes are because of the illness rather than at the root of it.

So the best answer is that researchers don’t know exactly what causes Hyperemesis Gravidarum, and the cause may be different for different women. More research is needed in this area.

Do I Have Hyperemesis Gravidarum or Just Morning Sickness?

Nearly half of pregnant women suffer from nausea and vomiting of pregnancy (NVP), or ‘morning sickness,’ that usually resolves without treatment by the end of the first trimester. While it may be challenging, it is not as incapacitating as HG. NVP typically does not cause weight loss or your ability to eat and drink enough each day. Though you may vomit occasionally with NVP, diet and lifestyle changes tend to help you feel better.

Women with HG, however, lose as much as 5-20 pounds (approx. 2-9 kgs), cannot eat or drink enough to maintain even a low level of hydration, suffer nearly unending nausea, and vomit severely (sometimes even vomiting blood and bile). Changes in diet that are often recommended, including bland foods and not letting your stomach get empty, aren’t enough to keep nausea at bay. Mothers-to-be with Hyperemesis Gravidarum often cannot work, and need help with daily self-care.

What Are The Health Consequences For The Mother-To-Be?

While most women don’t have any lasting health consequences from Hyperemesis Gravidarum, some women suffer complications. Unabated dehydration can lead to kidney stones, and even possibly renal failure. The severe fatigue may lead to muscular atrophy.

Not only do women with Hyperemesis Gravidarum have nutritional inadequacies, but they may suffer tears in the oesophagus from persistent vomiting and changes in the gastrointestinal tract including pH imbalance and gastric ulcers. Hyperemesis Gravidarum can also lead to deconditioning of the heart muscle, a decrease in blood volume, deficits in blood clotting, and constriction of blood vessels in the brain. The liver can be affected, potentially causing jaundice, and the spleen may separate from its normal location.

All body systems are affected by Hyperemesis Gravidarum. Women whose Hyperemesis Gravidarum is adequately treated as early in pregnancy as possible are at a lower risk for long-term health problems related to the HG.

What Are The Potential Complications For Baby?

Some researchers believe that chronic stress for a pregnant mother may lead to future health consequences for a fetus. Other complications include an increased risk of preterm birth, low birth weight, congenital heart defects, neural tube defects, and more. These consequence are theoretical because no studies have tracked the long-term health of babies born to women with Hyperemesis Gravidarum.

How Is It Treated?

Intravenous rehydration is typically the first line of treatment for Hyperemesis Gravidarum. This sometimes requires hospitalisation, with the length of therapy will depend on the severity of the symptoms. Often bed rest is recommended, and even if not, the fatigue a mother experiences leads to this anyway. Since maternal nutritiona is so important during pregnancy, nutritional therapy is often included as part of the HG treatment. This may mean parenteral nutrition (nutrition intravenously) in severe cases, and in milder cases, just working with a dietician to ensure the mother-to-be is taking in adequate calories and nutrients.

Medications are often part of the treatment regimen for women with Hyperemesis Gravidarum. The drugs most often prescribed for Hyperemesis Gravidarum fall into these categories: serotonin antagonists, corticosteroids, antihistamines, phenothiazines, anti-reflux medications, antispasmodics and prokinetic agents.

No drug is completely safe in pregnancy, but the benefits of pharmacologic therapy in most cases of hyperemesis greatly outweigh the risks.

What Can Support People Do To Help?

Partners and other support people may question if her symptoms are actually as severe as they seem — the best thing you can do is believe her, and to do anything you can to support her through this challenging time. She may need you to help her with even the most basic daily tasks. If you have other children, she will likely need help caring for them. She may feel anxious and depressed — these are common occurrences with Hyperemesis Gravidarum. She may need someone to advocate for her with healthcare providers, who may not have experience with her condition. Keep in mind that even when the nausea and vomiting abate, she will need to recover from this prolonged period of illness while still growing a baby inside — continued support may be needed for things like housekeeping, childcare and employment-related duties.

Will I Have HG Every Time I Am Pregnant?

Because no one knows what causes Hyperemesis Gravidarum, it cannot be prevented. But having gone through it once, you can be prepared. You will likely recognise the symptoms and seek treatment sooner with subsequent pregnancies. This early treatment may lessen the symptoms and severity of the HG.

The absolute best resource for mothers experiencing Hyperemesis Gravidarum is the Hyperemesis Education and Research Foundation. Visit their website at www.helpher.org for mother-to-mother forums, research, blog posts, and more. Share the website with your healthcare provider ” he or she can find a recommended protocol, as well as practice tools and current research. Share it with your family and friends so they can learn more about your condition, including the best ways to help. And share your experience with others through the Support Forums.

You don’t have to suffer with severe morning sickness. Find a physician who will take your symptoms seriously, and who will help you find a treatment regimen that works for you.

Last Updated: July 22, 2015




  1. I really wish I had received help with this in my two pregnancies. No one understood how debilitating it was and just kept telling me to eat ginger and it would soon end – totally useless advice. The second time around I knew nothing helped which was easier than constantly trying things that didn’t work and made it worse. My advice is to eat as well as possible before getting pregnant and find people who understand how seriously it affects your mental health as well. I was really worried how it might affect my baby and it was just so gruelling to endure. Best of luck to others going through it and to those not, be kind.

  2. Im 12w6days pregnant and ive off work for nearly 3weeks. This condition is terrible. My husband and i tried so long for this little miracle. Im trying everyday to little things at home but im so exhausted. I feel so sad that i cant be like most women who are glowing at this stage. I haven’t been able to be excited yet. If theres anyone who can help with coping please let me know. The worst thing is ppl are saying “im staying at home because of a little morning sickness “nobody understands.to anyone else suffering out there try to rest and eat slowly.

  3. I had this my whole pregnancy and was hospitalised 5 times I was monitored for 6 hours each time and stayed over night about 3 times out of th 5 times and the only medication that seemed to work was “ondansetron wafers” they are used for cancer patients and dissolve on the tongue very expensive tho, I ended up having my baby on his due date induced as I had pre-eclampsia as well and he was only 6 pound 13 so average size still small tho and I wouldn’t wish this sickness on anyone I had this from 5 weeks until the very day he was born

  4. I am suffering HG since week 9 and I am 23 weeks now. I was hospitalized for 6 times so far. I am in total depression. I am afraid that my baby will be born with health problems. I eat almost crust of bread and a spread of jam or boiled potatoes. He is my miracle after 6 years of trials to conceive. I cant imagine spending the remaining period like this. Please God help me.

    1. Hi, I too suffer from this from 6 weeks pregnant. I am now 17 and it is waring off! At one point I didn’t think I would be able to cope any longer but there is light at the end of the tunnel. I have been hospitalised 5 times now, down to 7 stone! I finally got the okay to get regular anti sickness injections from my GP and ensure drinks (contain 330 cals per drink) to take along with any food I can on the “not so bad days” (not that they come often). I’m not sure if you could try the same? Hope this helps

Leave a Reply

Please note: in order to prevent spam and inappropriate language, all comments are moderated before they appear. We appreciate your patience awaiting approval. BellyBelly receives many comments every day, and we are unable to approve them all as soon as they are posted.

Your email address will not be published. Required fields are marked *

loaded font roboto