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Hyperemesis Gravidarum
•Last Updated: June 4, 2023
Hyperemesis gravidarum is nausea and vomiting that occurs during pregnancy and can lead to dehydration, weight loss, and electrolyte imbalances. Hyperemesis gravidarum is different from morning sickness, which is mild nausea and vomiting during early pregnancy.
Hyperemesis Gravidarum falls under thePregnancy & Childrencategory.
Last Updated:June 4, 2023
Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that typically starts in the first trimester and can last until delivery; it affects appproximately 1% to 3% of pregnancies. It can lead to serious complications such as dehydration, weight loss, and adverse effects on both the mother’s mental health and the fetus.
The main signs and symptoms of hyperemesis gravidarum include severe nausea, frequent vomiting, increased salivation, and loss of appetite; it typically starts at approximately 6 weeks of gestation. This condition can lead to serious complications such as weight loss, electrolyte imbalances, and psychosocial effects, and symptoms potentially last until the third trimester or beyond.
Hyperemesis gravidarum is diagnosed based on early signs and symptoms (such as severe nausea and vomiting, dehydration, and significant weight loss) and ruling out of other causes. Clinicians may also perform assessments, laboratory tests, and ultrasounds to evaluate the condition's severity and the fetus's health.
Medical treatments for hyperemesis gravidarum focus on managing symptoms and preventing complications; they typically involve rehydration, nutritional support, and antinausea medications. Common medications include promethazine, ondansetron, and metoclopramide, and some people require hospitalization or tube feeding in severe cases.
Hyperemesis gravidarum can lead to the depletion of essential vitamins like thiamine and vitamin K, which necessitates their repletion as part of standard medical care. Although pyridoxine and ginger are effective for treating mild to moderate nausea, they are not effective for treating the severe symptoms associated with hyperemesis gravidarum.
In hyperemesis gravidarum, it's important to eat pregnancy-safe, tolerable foods. Small, frequent meals of bland, protein-rich or carbohydrate-rich foods are typically better tolerated than strong-smelling or high-fat foods.
Low-quality evidence suggests that acupuncture and acupressure may help reduce nausea in hyperemesis gravidarum. Additionally, hypnotherapy and psychotherapy may serve as beneficial adjunctive treatments for some individuals.
The causes of hyperemesis gravidarum are not fully understood but are believed to be multifactorial, and genetics play a significant role. Hormonal changes during pregnancy may also contribute to the risk, although the evidence is inconsistent.
Research FeedRead all studies
- ^Boelig RC, Barton SJ, Saccone G, Kelly AJ, Edwards SJ, Berghella VInterventions for treating hyperemesis gravidarum: a Cochrane systematic review and meta-analysis.J Matern Fetal Neonatal Med.(2018-Sep)
- ^Matthews A, Haas DM, O'Mathúna DP, Dowswell TInterventions for nausea and vomiting in early pregnancyCochrane Database Syst Rev.(2015 Sep 8)
- ^London V, Grube S, Sherer DM, Abulafia OHyperemesis Gravidarum: A Review of Recent LiteraturePharmacology.(2017)
- ^Poursharif B, Korst LM, Fejzo MS, MacGibbon KW, Romero R, Goodwin TMThe psychosocial burden of hyperemesis gravidarum.J Perinatol.(2008-Mar)
- ^Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJConsequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis.BJOG.(2011-Oct)
- ^Austin K, Wilson K, Saha SHyperemesis Gravidarum.Nutr Clin Pract.(2019-Apr)
- ^Popa SL, Barsan M, Caziuc A, Pop C, Muresan L, Popa LC, Perju-Dumbrava LLife-threatening complications of hyperemesis gravidarum.Exp Ther Med.(2021-Jun)
- ^Goodwin TMHyperemesis gravidarum.Obstet Gynecol Clin North Am.(2008-Sep)
- ^Nurmi M, Rautava P, Gissler M, Vahlberg T, Polo-Kantola PReadmissions due to hyperemesis gravidarum: a nation-wide Finnish register study.Arch Gynecol Obstet.(2022-Nov)
- ^Heitmann K, Nordeng H, Havnen GC, Solheimsnes A, Holst LThe burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again - results from a cross-sectional studyBMC Pregnancy Childbirth.(2017 Feb 28)
- ^Poursharif B, Korst LM, Macgibbon KW, Fejzo MS, Romero R, Goodwin TMElective pregnancy termination in a large cohort of women with hyperemesis gravidarum.Contraception.(2007-Dec)
- ^Nijsten K, Dean C, van der Minnen LM, Bais JMJ, Ris-Stalpers C, van Eekelen R, Bremer HA, van der Ham DP, Heidema WM, Huisjes A, Kleiverda G, Kuppens SM, van Laar JOEH, Langenveld J, van der Made F, Papatsonis D, Pelinck MJ, Pernet PJ, van Rheenen-Flach L, Rijnders RJ, Scheepers HCJ, Vogelvang T, Mol BW, Roseboom TJ, Koot MH, Grooten IJ, Painter RCRecurrence, postponing pregnancy, and termination rates after hyperemesis gravidarum: Follow up of the MOTHER study.Acta Obstet Gynecol Scand.(2021-Sep)
- ^Nijsten K, van der Minnen LM, Dean C, Bais JMJ, Ris-Stalpers C, van Eekelen R, Bremer HA, van der Ham DP, Heidema WM, Huisjes A, Kleiverda G, Kuppens SM, van Laar JOEH, Langenveld J, van der Made F, Papatsonis D, Pelinck MJ, Pernet PJ, van Rheenen-Flach L, Rijnders RJ, Scheepers HCJ, Vogelvang T, Mol BW, Olff M, Roseboom TJ, Koot MH, Grooten IJ, Painter RCDepression, anxiety, and post-traumatic stress disorder symptoms after hyperemesis gravidarum: a prospective cohort study.J Matern Fetal Neonatal Med.(2022-Dec)
- ^L A W Jansen, M H Koot, J Van't Hooft, C R Dean, P M M Bossuyt, W Ganzevoort, N Gauw, B Y Van der Goes, J Rodenburg, T J Roseboom, R C Painter, I J GrootenThe windsor definition for hyperemesis gravidarum: A multistakeholder international consensus definitionEur J Obstet Gynecol Reprod Biol.(2021 Nov)
- ^Marlena S Fejzo, Jone Trovik, Iris J Grooten, Kannan Sridharan, Tessa J Roseboom, Åse Vikanes, Rebecca C Painter, Patrick M MullinNausea and vomiting of pregnancy and hyperemesis gravidarumNat Rev Dis Primers.(2019 Sep 12)
- ^ACOG Practice Bulletin No. 189 Summary: Nausea And Vomiting Of Pregnancy.Obstet Gynecol.(2018 Jan)
- ^McParlin C, O'Donnell A, Robson SC, Beyer F, Moloney E, Bryant A, Bradley J, Muirhead CR, Nelson-Piercy C, Newbury-Birch D, Norman J, Shaw C, Simpson E, Swallow B, Yates L, Vale LTreatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy: A Systematic Review.JAMA.(2016-Oct-04)
- ^Van den Heuvel E, Goossens M, Vanderhaegen H, Sun HX, Buntinx FEffect of acustimulation on nausea and vomiting and on hyperemesis in pregnancy: a systematic review of Western and Chinese literature.BMC Complement Altern Med.(2016-Jan-13)
- ^Ozgunay SE, Dincgez B, Karasu D, Ozgen G, Taymur I, Eminoglu S, Ceylan IAdjuvant Hypnotherapy for Hyperemesis Gravidarum: A Randomized Pilot Study.Int J Clin Exp Hypn.(2022)
- ^Torem MSHypnotherapeutic techniques in the treatment of hyperemesis gravidarum.Am J Clin Hypn.(1994-Jul)
- ^Fejzo MS, Ingles SA, Wilson M, Wang W, MacGibbon K, Romero R, Goodwin TMHigh prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals.Eur J Obstet Gynecol Reprod Biol.(2008-Nov)
- ^Fejzo MS, Sazonova OV, Sathirapongsasuti JF, Hallgrímsdóttir IB, Vacic V, MacGibbon KW, Schoenberg FP, Mancuso N, Slamon DJ, Mullin PM,Placenta and appetite genes GDF15 and IGFBP7 are associated with hyperemesis gravidarum.Nat Commun.(2018-Mar-21)
- ^Liu C, Zhao G, Qiao D, Wang L, He Y, Zhao M, Fan Y, Jiang EEmerging Progress in Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum: Challenges and Opportunities.Front Med (Lausanne).(2021)
- ^Dean CR, Bruin CM, O'Hara ME, Roseboom TJ, Leeflang MM, Spijker R, Painter RCThe chance of recurrence of hyperemesis gravidarum: A systematic review.Eur J Obstet Gynecol Reprod Biol X.(2020-Jan)
- ^Ng QX, Venkatanarayanan N, De Deyn MLZQ, Ho CYX, Mo Y, Yeo WSA meta-analysis of the association between Helicobacter pylori (H. pylori) infection and hyperemesis gravidarum.Helicobacter.(2018-Feb)
- ^Jansen LAW, Nijsten K, Limpens J, van Eekelen R, Koot MH, Grooten IJ, Roseboom TJ, Painter RCPerinatal outcomes of infants born to mothers with hyperemesis gravidarum: A systematic review and meta-analysis.Eur J Obstet Gynecol Reprod Biol.(2023-May)
- ^Morisaki N, Nagata C, Morokuma S, Nakahara K, Kato K, Sanefuji M, Shibata E, Tsuji M, Shimono M, Kawamoto T, Ohga S, Kusuhara K,Lack of catch-up in weight gain may intermediate between pregnancies with hyperemesis gravidarum and reduced fetal growth: the Japan Environment and Children's Study.BMC Pregnancy Childbirth.(2022-Mar-12)
- ^Dodds L, Fell DB, Joseph KS, Allen VM, Butler BOutcomes of pregnancies complicated by hyperemesis gravidarum.Obstet Gynecol.(2006-Feb)
- ^Nijsten K, Jansen LAW, Limpens J, Finken MJJ, Koot MH, Grooten IJ, Roseboom TJ, Painter RCLong-term health outcomes of children born to mothers with hyperemesis gravidarum: a systematic review and meta-analysis.Am J Obstet Gynecol.(2022-Sep)
- ^Koren G, Maltepe CPre-emptive therapy for severe nausea and vomiting of pregnancy and hyperemesis gravidarum.J Obstet Gynaecol.(2004-Aug)
- ^Cao X, Sun M, Yang Q, Wang Q, Hou L, Wang J, Wu Y, Ge LRisk of abnormal pregnancy outcomes after using ondansetron during pregnancy: A systematic review and meta-analysis.Front Pharmacol.(2022)
- ^Pasternak B, Svanström H, Mølgaard-Nielsen D, Melbye M, Hviid AMetoclopramide in pregnancy and risk of major congenital malformations and fetal death.JAMA.(2013-Oct-16)
- ^Dormuth CR, Winquist B, Fisher A, Wu F, Reynier P, Suissa S, Dahl M, Ma Z, Lu X, Zhang J, Raymond CB, Filion KB, Platt RW, Moriello C, Paterson JM,Comparison of Pregnancy Outcomes of Patients Treated With Ondansetron vs Alternative Antiemetic Medications in a Multinational, Population-Based Cohort.JAMA Netw Open.(2021-Apr-01)
- ^Fejzo MS, MacGibbon KW, Mullin PMOndansetron in pregnancy and risk of adverse fetal outcomes in the United States.Reprod Toxicol.(2016-Jul)
- Nausea Symptoms - Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping UGinger treatment of hyperemesis gravidarumEur J Obstet Gynecol Reprod Biol.(1991 Jan 4)
- Nausea Symptoms - Smith C, Crowther C, Willson K, Hotham N, McMillian VA randomized controlled trial of ginger to treat nausea and vomiting in pregnancyObstet Gynecol.(2004 Apr)
- Nausea Symptoms - Ernst E, Pittler MHEfficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trialsBr J Anaesth.(2000 Mar)