Severe vomiting in pregnancy: hyperemesis gravidarum

Around 7 out of every 10 pregnant women experience nausea or vomiting. Up to 1 in every 100 pregnant women experience excessive vomiting, known as hyperemesis gravidarum (HG). They often need hospital treatment as they are unable to eat.

Symptoms
If you have HG, you can experience the following symptoms:

• Severe nausea and vomiting 
• Dehydration from not having enough fluids in your body
• Ketosis, which is a serious condition that results in the build-up of acidic chemicals in the blood and urine 
• Weight loss
• Low blood pressure when standing

How it progresses
Unlike regular pregnancy sickness, HG may not get better by 14 weeks. It may not clear up completely until the baby is born, although some symptoms may improve at around 20 weeks. See your doctor if you have severe nausea and vomiting.

Causes
It’s unknown what causes HG, or why some women get it and others don’t. However, some doctors believe it is linked to the changing hormones in your body during pregnancy.

Treating hyperemesis gravidarum
Safe medications that improve the symptoms of HG include:

• Anti-sickness drugs
• Vitamins (B6 and B12) 
• Steroids

Evidence suggests that the earlier you start treatment, the more effective it will be. You may need to try different types of medication until you find what works best for you. Always talk to your doctor before you take any medication. 

Need for hospital admission
If you can not control your vomiting, you may need to be admitted to the hospital so that doctors can assess your condition and give you the right treatment to protect you and your little one.

Will it harm my baby?
HG is unpleasant, but the good news is it’s unlikely to harm your baby unless you lose too much weight during pregnancy, which increases the risk that your baby may be born smaller than expected.

You may also need special support
HG can affect you both emotionally and physically. The symptoms not only make your life miserable but may lead to further health complications, such as depression. The illness can be exhausting and stop you from doing everyday tasks. You might also feel:

• Anxious about going out or being too far from home in case you need to vomit
• Isolated and confused as to why this is happening to you
• Unsure whether you can cope with the rest of the pregnancy if you continue to feel very ill

How to get emotional support?
Talk to your partner, family, or doctor, and explain the impact HG is having on your life and how it makes you feel.