Hyperemesis Gravidarum Quiz
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Nausea
Malaise
Fatigue
Dehydration
Cottonmouth
Dry mouth
Loss of appetite
Loss of taste and smell
Diarrhea and vomiting
Weight loss
Dehydration headache
Extreme tiredness
Not seeing your symptoms? No worries!
What is Hyperemesis Gravidarum?
A severe form of morning sickness, where patients have significant vomiting and are typically unable to keep much food or fluids down. They can lose weight and become very dehydrated. The exact cause is unclear, but it's thought to be related to levels of pregnancy hormones (β-hCG and estrogen). Early treatment of morning sickness can help prevent progression to this severe form. There is typically no harm to the developing baby from this condition, but it is important to maintain normal hydration and weight in the mom.
Typical Symptoms of Hyperemesis Gravidarum
- Having difficulty urinating or producing less urine
- Currently pregnant
- Possibility of being pregnant
- Nausea or vomiting
- Changes in taste
- Recent weight loss
- Dry mouth
- Fatigue or low energy
Diagnostic Questions for Hyperemesis Gravidarum
Your doctor may ask these questions to check for this disease:
- Have you been experiencing difficulty urinating or producing less urine?
- Are you pregnant?
- Is there any chance that you might be pregnant?
- Have you been experiencing nausea or vomiting?
- Have you experienced any changes in your sense of taste?
Treatment of Hyperemesis Gravidarum
Treatment depends on the severity of the condition. Some severely dehydrated patients may need hospitalization and fluids given through a needle in the vein (IV fluids). Medications can be given to reduce the nausea and vomiting, and help with tolerance of oral food and fluids. Many patients will have improvement in symptoms as the pregnancy advances into the second and third trimester.
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Dec 13, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Decreased urine output
- Not peeing enough
- Drinking lots of water but not urinating much
- Have nausea
- No urine output in 12 hours
- Loss of taste
- Urinating less than normal
- Very difficult to urinate
- Reduction in urine volume
- Nausea improves with vomiting
- Unable to empty bladder completely
- Taste is out of the ordinary
- Bile vomiting
- Sudden change in taste
- Nausea and vomiting after a meal
See full list
Symptoms Related to Hyperemesis Gravidarum
Diseases Related to Hyperemesis Gravidarum
FAQs
Q.
Can’t Stop Vomiting? Why Hyperemesis Gravidarum Occurs & Medically Approved Next Steps
A.
If you cannot stop vomiting in pregnancy, it may be hyperemesis gravidarum, a serious condition tied to rising hCG, genetics, and digestive or thyroid changes that can cause dehydration and weight loss and needs prompt medical care; there are several factors to consider, see below to understand more. Medically approved next steps include vitamin B6 with doxylamine, prescription antiemetics, IV fluids with electrolytes and thiamine, and in severe cases nutritional support or hospitalization; seek urgent care if you cannot keep fluids down for 24 hours, are not urinating, feel faint, have severe pain, or see blood in vomit, and find complete guidance on symptoms, diagnosis, and safer treatment options below.
References:
* MacKenzie, A., Torgerson, D. J., & The American College of Obstetricians and Gynecologists. (2018). Nausea and Vomiting in Pregnancy: ACOG Practice Bulletin, Number 189. *Obstetrics & Gynecology*, *131*(1), e15-e30. PMID: 29278035.
* van Kuyl, G. M. A., & Bouts, A. (2022). Current understanding of hyperemesis gravidarum. *Netherlands Journal of Medicine*, *80*(7), 299-307. PMID: 36473041.
* Fejzo, M. S., & Vella, J. (2021). Hyperemesis Gravidarum: An Update in 2021. *Journal of Clinical Gastroenterology*, *55*(9), 749-756. PMID: 33909774.
* Dean, L. T., & Fejzo, M. S. (2018). Hyperemesis Gravidarum: A Review of Pathophysiology and Current Management. *Journal of Clinical Gastroenterology*, *52*(8), 666-671. PMID: 29505524.
* Dean, L. T., Fejzo, M. S., & Vella, J. (2020). Hyperemesis Gravidarum: A Management Algorithm. *Journal of Clinical Gastroenterology*, *54*(1), 10-14. PMID: 31033501.
Q.
Is it HG? Why Your Body is Rejecting Food & Medically Approved Next Steps
A.
If you're pregnant and your body seems to reject food or even water, that may be hyperemesis gravidarum, a severe condition beyond morning sickness marked by relentless nausea, repeated vomiting, dehydration, and weight loss. There are several factors to consider; see below for how to tell it apart from typical morning sickness, the red flags, how HG is diagnosed, and when to seek urgent evaluation. Medically approved next steps include early vitamin B6 with doxylamine or other prescription anti nausea medicines, prompt IV fluids and electrolytes if you cannot keep fluids down, and nutrition support when needed, and you should seek urgent care if you go 24 hours without tolerating fluids, show dehydration, or have rapid weight loss, with important details below that could change your next step.
References:
* Maltepe C, Koren G. Hyperemesis Gravidarum: A Comprehensive Review. J Matern Fetal Neonatal Med. 2022 Dec;35(25):4974-4981. doi: 10.1080/14767058.2021.1969248. PMID: 34493010.
* Fejzo MS, Salih SM, Ostrom C, MacGibbon KW, Mullin PM. Hyperemesis Gravidarum: Pathophysiology, Clinical Presentation, and Management. J Pregnancy. 2023 Apr 12;2023:6699742. doi: 10.1155/2023/6699742. PMID: 37070189.
* Niebyl JR. Pathogenesis and Management of Hyperemesis Gravidarum. J Perinatol. 2020 Mar;40(3):355-361. doi: 10.1038/s41372-020-0348-7. PMID: 32014101.
* Goodman E, Kim J, Maltepe C, Fejzo MS, Koren G. The Role of GDF15 in Hyperemesis Gravidarum: A Systematic Review. J Clin Med. 2024 Jan 26;13(3):666. doi: 10.3390/jcm13030666. PMID: 38318712.
* Niemeijer MN, Grooten IJ, Vos N, van der Post JAM, Stelloo K, Mol BWJ, Bais JM. Treatment of Hyperemesis Gravidarum: An Evidence-Based Approach. J Perinatol. 2020 Mar;40(3):362-371. doi: 10.1038/s41372-019-0560-z. PMID: 31804961.
Q.
Zofran for Women 30-45: Side Effects, Safety & Your Next Steps
A.
Zofran for women 30 to 45 can be highly effective for severe nausea from pregnancy, migraines, or surgery, but there are several factors to consider; common side effects include headache, constipation, dizziness, and flushing, and rare but serious risks include QT related heart rhythm problems and serotonin syndrome, especially with heart disease, electrolyte issues, or interacting medications. In pregnancy, most data are reassuring with a low absolute risk of certain defects, yet treatment should balance symptom severity against risks; review your meds and heart history with your clinician, stay hydrated, monitor for red flags like chest pain, fainting, irregular heartbeat, or confusion, and see the complete answer below for important details on interactions, dosing, and urgent next steps.
References:
* Hajovsky H, Kopecky J, Maleninska K, Kopecky M, Vrbkova J. Cardiac effects of ondansetron in adults: a systematic review and meta-analysis. Eur J Clin Pharmacol. 2021 Apr;77(4):475-486. doi: 10.1007/s00228-020-03043-3. Epub 2021 Jan 27. PMID: 33507316.
* Wang Y, Li Z, Zhang S, Zhang Z. Safety profile of ondansetron in adult patients: A systematic review and meta-analysis. Front Pharmacol. 2022 Nov 29;13:1018901. doi: 10.3389/fphar.2022.1018901. eCollection 2022. PMID: 36523908.
* Stowe J, Haque S, Alam N, Taylor D. Serotonin syndrome associated with ondansetron and selective serotonin reuptake inhibitors: a systematic review of cases. J Psychopharmacol. 2017 Mar;31(3):355-364. doi: 10.1177/0269881116684781. Epub 2016 Dec 20. PMID: 28024503.
* Wong JK, Tan G, Ng CH, Al Qadumi M, Finkelstein Y, Koren G. Systematic review of the safety and efficacy of ondansetron in adults. Br J Clin Pharmacol. 2017 Nov;83(11):2345-2358. doi: 10.1111/bcp.13331. Epub 2017 Aug 22. PMID: 28862660.
* Paliwal Y, Kapse J, Kalane U, Patel D. Risk of QT Prolongation and Torsades de Pointes with Ondansetron: A Pharmacovigilance Study. Drug Saf. 2020 Sep;43(9):885-896. doi: 10.1007/s40264-020-00945-8. PMID: 32266580.
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Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
London V, Grube S, Sherer DM, Abulafia O. Hyperemesis Gravidarum: A Review of Recent Literature. Pharmacology. 2017;100(3-4):161-171. doi: 10.1159/000477853. Epub 2017 Jun 23. PMID: 28641304.
https://www.karger.com/Article/FullText/477853Abramowitz A, Miller ES, Wisner KL. Treatment options for hyperemesis gravidarum. Arch Womens Ment Health. 2017 Jun;20(3):363-372. doi: 10.1007/s00737-016-0707-4. Epub 2017 Jan 9. PMID: 28070660; PMCID: PMC7037589.
https://link.springer.com/article/10.1007/s00737-016-0707-4Austin K, Wilson K, Saha S. Hyperemesis Gravidarum. Nutr Clin Pract. 2019 Apr;34(2):226-241. doi: 10.1002/ncp.10205. Epub 2018 Oct 18. PMID: 30334272.
https://onlinelibrary.wiley.com/doi/10.1002/ncp.10205Dean CR, Shemar M, Ostrowski GAU, Painter RC. Management of severe pregnancy sickness and hyperemesis gravidarum. BMJ. 2018 Nov 30;363:k5000. doi: 10.1136/bmj.k5000. PMID: 30504245.
https://www.bmj.com/content/363/bmj.k5000ACOG Practice Bulletin
https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2018/01/nausea-and-vomiting-of-pregnancy