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Severe vomiting during pregnancy (hyperemesis gravidarum)

2-minute read

Nausea and vomiting are common in pregnancy, especially in the first trimester. Some pregnant women experience excessive nausea and vomiting. This condition is known as 'hyperemesis gravidarum' and often needs hospital treatment.

Hyperemesis gravidarum isn’t common but it can be severe. It's much worse than morning sickness. If you're being sick all the time and can't keep food down, tell your midwife or doctor as soon as possible.

Symptoms of hyperemesis gravidarum

Excessive vomiting in pregnancy is much worse than the nausea and vomiting of morning sickness. Symptoms usually start between 4 and 9 weeks of pregnancy and usually improve by 15 to 20 weeks. Signs and symptoms of hyperemesis gravidarum include:

  • prolonged and severe nausea and vomiting
  • dehydration
  • ketosis — a serious condition that is caused by a raised number of ketones in the blood and urine (ketones are poisonous acidic chemicals that are produced when your body breaks down fat, rather than glucose, for energy)
  • weight loss
  • low blood pressure (hypotension) when standing up
  • headaches, confusion, fainting and jaundice

The nausea and vomiting are usually so severe that it's impossible to keep any fluids down, and this can cause dehydration and weight loss. Dehydration is when you don’t have enough fluids in your body.

Hyperemesis gravidarum is very unpleasant with dramatic symptoms, but the good news is it’s unlikely to harm your baby. However, if it causes you to lose weight during pregnancy there is an increased risk that your baby may be born smaller than expected.

Treating hyperemesis gravidarum

Mild cases of hyperemesis gravidarum may be controlled with a change in diet, rest and antacids. Severe cases may need specialist treatment, and you may need to be admitted to hospital so that doctors can assess your condition and give you the right treatment. This can include intravenous fluids given through a drip to treat the ketosis and treatment to stop the vomiting.

Don’t take medication for hyperemesis gravidarum without talking to your doctor first.

Blood clots and hyperemesis gravidarum

Because hyperemesis gravidarum can cause dehydration, there's also an increased risk of having deep vein thrombosis (a blood clot). Read more about deep vein thrombosis on healthdirect.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: August 2020


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