Severe Nausea And Vomiting (Hyperemesis)


Nausea and vomiting during pregnancy is not uncommon. However, some women experience very severe morning sickness referred to as hyperemesis gravidarum. Hyperemesis in pregnancy can cause you to vomit several times during the day. In the most severe of cases, you may require supportive care and IV fluids in a hospital to reverse the dehydration.

What Causes this Severe Nausea and Vomiting?

While the exact cause is unknown, it is believed that certain hormone levels rising rapidly can cause the condition. These hormones include estrogen and human chorionic gonadotropin (HCG). Certain risk factors may increase your risk of this condition:

  • Abnormal cells growing in your uterus
  • Being pregnant with more than one baby
  • A history of hyperemesis gravidarum
  • Your first pregnancy
  • Being overweight

Diagnosing Hyperemesis Gravidarum

In most cases, you will start having symptoms during your first trimester if you have this condition. If you are pregnant and experiencing the following as a result of vomiting, it may indicate this condition:

  • Losing over 10 pounds
  • Experiencing dehydration
  • Getting lightheaded or dizzy
  • Vomiting at least three times a day

Other symptoms can include:

  • Severe nausea and vomiting
  • Reduced urination
  • Headaches
  • Fainting
  • Extreme fatigue
  • Rapid heart rate
  • Secondary depression and anxiety
  • Food aversions
  • Confusion
  • Jaundice
  • Low blood pressure
  • Loss of skin elasticity

Treatment Options

Once you get a definitive diagnosis, we will work with you to develop a management plan. There is no cure, but there are ways to reduce nausea and vomiting so that you can be more comfortable during your pregnancy.

First, we suggest making dietary changes to aid with your symptoms. It is common to get relief from eating smaller meals frequently throughout the day instead of eating bigger meals two or three times a day. Start with dry foods, such as crackers and oatmeal, as these tend to cause less nausea, especially compared to highly seasoned or fatty foods. Try eating before or as soon as you feel hungry to avoid an empty stomach.

Meals that are high in protein or carbohydrates and low in fat tend to aid in relieving symptoms. 

Sticking to a bland diet and drinking cold, clear, and carbonated or sour fluids (eg, ginger ale, lemonade) in small amounts between meals.

Smelling fresh lemon, mint, or orange or using an oil diffuser with these scents may also be useful.


In spite of lifestyle modifications, some women may not get relief. We will weigh the pros and cons and talk to you about medications that can help to reduce your nausea and vomiting episodes. These are usually given orally. However, if you cannot take oral medicines, there are some suppository and IV options that we can discuss. Common medications to control nausea include diclegis, promethazine, and ondansetron.

Hospital-Based Treatments

If nausea and vomiting prevent you from getting enough fluids and nutrients, you may be admitted to the hospital to administer these. Home health care could also be an option for some women to receive these treatments.

If you are pregnant and are experiencing severe vomiting, it is important to contact your doctor. In Atlanta, Georgia, contact Northside/Northpoint OB-GYN and make your appointment today. Your doctor will evaluate your symptoms and help you to develop a management plan that works for you and your pregnancy.

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