(Severe Morning Sickness; Persistent Vomiting of Pregnancy; HG)
- Vitamin B deficiency
- Human chorionic gonadotropin (hyperemesis most severe during period of highest HCG levels)
- Hyperthyroidism (may be a result of high chorionic gonadotropin levels)
- Endocrine imbalances (high levels of estrogen)
- A multiple pregnancy (twins or more)
- Brain nausea-control-center sensitivity to pregnancy changes
|The Brain May Be Cause of Nausea|
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- History of HG in previous pregnancies
- Molar pregnancy (an abnormal mass made up of placental tissue; may or may not contain some fetal tissue)
- Mother or sister with HG
- A multiple pregnancy
- Young maternal age
- No previous completed pregnancies
- First-time pregnancy
- Severe and persistent vomiting, beginning 4 to 6 weeks after conception, peaking 9-13 weeks, and usually improving and ending 14-20 weeks
- Progressive weight loss of greater than 5% of original, pre-pregnancy body weight
Dehydration, which may show the following signs:
- Ketones in urine
- Increased hematocrit (% of red blood cells in blood)
- Increased pulse rate
- Decreased blood pressure
- Rapid heartbeat (tachycardia)
- Excessive salivation (ptyalism)
- Distinctive breath odor (ketonic odor)
- Weight measurement—to determine if you have lost weight
- Blood electrolytes—to identify disturbances in salts and other minerals in the blood due to extreme vomiting
- Ketones—to determine if you are dehydrated
- Overall condition—ability to perform daily activities; psychological state of mind
IV Hydration and Anti-nausea Medications
Nutrition by Vein
Termination of Pregnancy
- Avoiding smells, foods, or other things that stimulate nausea
- Eating frequent small meals
- Not allowing yourself to get too hungry or too full
The American Congress of Obstetricians and Gynecologists http://www.acog.org
Hyperemesis Education and Research Foundation http://www.helpher.org
National Organization for Rare Diseases http://www.rarediseases.org
The Canadian Women's Health Network http://www.cwhn.ca/en
The Society of Obstetricians and Gynaecologists of Canada (SOGC) http://www.sogc.org/index%5Fe.asp
ACOG issues guidance on the treatment of morning sickness during pregnancy. American College of Obstetrics and Gynecology website. Available at: http://www.acog.org/About%5FACOG/News%5FRoom/News%5FReleases/2004/ACOG%5FIssues%5FGuidance%5Fon%5FTreatment%5Fof%5FMorning%5FSickness%5FDuring%5FPregnancy. Accessed August 20, 2011.
Acupuncture. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary. Updated January 2009. Accessed January 19, 2009.
Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999.
Burrow GN, Duffy TP, eds. Medical Complications During Pregnancy. 5th ed. Philadelphia, PA: WB Saunders Company; 1999.
Cunningham FG, Gilstrap LC, Gant NF, Hauth JC, Leveno KJ, Wenstrom KD, eds. Williams Obstetrics. 21st ed. New York, NY: McGraw-Hill; 2001.
Ferri, Fred, ed. Ferri’s Clinical Advisor 2010. 1st ed. Philadelphia: Mosby Elsevier, 2009.
Gabbe SG, Niebyl JR, Simpson JL. Obstetrics: Normal and Problem Pregnancies. 5th ed. United Kingdom: Churchill Livingstone; 2007.
Gastroenterology Clinics of North America. Philadelphia, PA: WB Saunders.
Hyperemesis Education and Research Foundation website. Available at: http://www.helpher.org.
Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, eds. Harrison’s Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill Companies, Inc; 2005.
Mahan LK, Escott-Stump S, eds. Krause’s Food, Nutrition, and Diet Therapy. 10th ed. Philadelphia, PA: WB Saunders Company; 2000.
Marx J, et al. Rosen's Emergency Medicine. 7th ed. St. Louis, MO: Mosby, Inc., 2009.
National Organization for Rare Diseases website. Available at: http://www.rarediseases.org
Nausea and vomiting in pregnancy. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com. Updated October 2010. Accessed October 25, 2010.
Quinlan JD, Hill DA. Nausea and vomiting of pregnancy. Am Fam Physician. 2003;68:121-128. American Family Physician website. Available at: http://www.aafp.org/afp/20030701/121.html. Accessed August 12, 2005.
Sadock BJ, Sadock VA, eds. Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 9th ed. Philadelphia, PA: Lippincott, Williams and Wilkins; 2003.
Wise MG, Rundell JR, eds. The American Psychiatric Publishing Textbook of Consultation-Liaison Psychiatry: Psychiatry in the Medically Ill. 2nd ed. Washington, DC: American Psychiatric Publishing, Inc.; 2002.
- Reviewer: Andrea Chisholm
- Review Date: 09/2012 -
- Update Date: 00/92/2012 -