What Is Hyperemesis Gravidarum?

Medically Reviewed by Traci C. Johnson, MD on August 19, 2022
3 min read

Many pregnant women have morning sickness. But for a few, it’s much more intense. Less than 3% of pregnant women get something called hyperemesis gravidarum. There's no cure for it, but it's temporary, and there are ways to manage it.

When you have hyperemesis gravidarum, you vomit a lot, sometimes almost constantly. This can lead to problems like dehydration and weight loss. Morning sickness often fades by the end of the first trimester, but hyperemesis gravidarum usually lasts longer.

It generally strikes between the 4th and 6th week of pregnancy, and may be at its worst around weeks 9 to 13. The vomiting is so severe, most women are unable to go about their typical daily activities. Symptoms usually get better by the 20th week, but not always.

Doctors don't know what causes it, but they believe it's related to a rise in hormone levels.

Women who had the condition during their first pregnancy have a higher chance of getting it again during the next one. There’s no known way to prevent it, though taking a multivitamin before getting pregnant may help a little.

Hyperemesis gravidarum can cause problems for both you and your baby. It can affect:

  • Your weight. Losing 5% is common.
  • Your kidneys. They may stop working well, causing you to pee less than you should.
  • Your mineral balance. You may have low levels of minerals, called electrolytes, that your body needs. They include sodium and potassium. When you don't have enough, it can cause dizziness, weakness, and changes in blood pressure.
  • Your muscles. Malnutrition, electrolyte imbalance, and the need for bed rest can weaken your muscles.
  • Your saliva. You may make too much. Swallowing it may make nausea even worse.

Your doctor will need to help you manage this. Without treatment, there’s a higher chance your baby will be born prematurely or have a low birth weight. Either of these can put them at risk for health problems.

Treatment depends on your symptoms and how the condition is affecting your health. Up to 5% of women with the condition need to check in to a hospital. Your doctor may first recommend:

  • Lifestyle changes. If you can eat, have smaller, more frequent meals. Drink smaller drinks, but drink more often, and through a straw. Try cold foods if hot ones trigger nausea. Your doctor may want you to drink electrolyte-replacement sports drinks and nutritional supplements. Get enough sleep and try to manage your stress.
  • Ginger. Taking 1 to 1.5 grams a day in several small doses may help some women. You can get it in tea, lollipops, or supplements.
  • Pyridoxine. This vitamin, known as vitamin B6, is often prescribed for nausea in pregnancy. Typical doses are 10 mg to 25 mg, 3 times a day. Taking more may lead to temporary nerve damage.

  • Thiamine. This vitamin (also called vitamin B1) in doses of 1.5 milligrams a day may ease vomiting.

  • Medications. Your doctor can prescribe one or more drugs to help you throw up less. You can take them by mouth, suppository, IV, or in a shot. Antacids can also help. Another possible treatment is IV steroids. Your doctor will make sure any medications you take are safe for your baby.

If you're still throwing up and dehydrated, your doctor may recommend you check in to the hospital. Once there you may get:

  • IV fluids. Doctors will give you saline and possibly electrolytes and vitamins to help keep you hydrated.
  • Tube feeding. If you can’t keep anything down, the doctor may give you nutrition through a tube that goes through your nose and into your stomach. In extreme cases you may need a tube connected directly to your stomach or small intestine.
  • IV feeding. This bypasses the stomach altogether.

Once you aren't vomiting so much and are able to hold down food and remain hydrated, you may be able to stop treatments.

Try to remember that it does eventually stop -- and the birth of your baby will follow.