Excessive Vomiting: Hyperemesis gravidarum – Encyclopedia of Medicine & Health

Excessive vomiting: hyperemesis gravidarum

Doctors speak of hyperemesis gravidarum (excessive vomiting during pregnancy) when pregnant women vomit more than five times a day or subsequently lose more than 5 percent of their body weight. Between 0.5 and 2 percent of all pregnant women are affected worldwide. Only rarely do life-threatening illnesses occur.

What is hyperemesis gravidarum?

The doctor divides hyperemesis gravidarum into two degrees:

  • Grade 1 is characterized by nausea, vomiting and a classic feeling of illness.
  • Degree 2 is noticeable through an additionally disturbed mineral and water balance, whereby the metabolism of the pregnant woman is also disturbed.

However, hyperemesis gravidarum has nothing to do with emesis gravidarum (morning sickness). This usually only occurs at the beginning of pregnancy. The symptoms and complaints are also significantly less than with hyperemesis gravidarum.

Constant nausea: causes of excessive vomiting in pregnancy

So far there are no precise reasons why hyperemesis gravidarum can occur. However, there are some risk factors that sometimes favor hyperemesis gravidarum. These include obesity , allergies , multiple pregnancies , severe obesity, diseases of the outer amniotic sac, hyperfunction of the thyroid gland , hyperfunction of the parathyroid glands or disorders of liver function or lipid metabolism .Anorexia and binge eating can also promote hyperemesis gravidarum. Sometimes it is also due to the pregnancy hormone hCG ( human chorionic gonadotropin ). The hormone is “known” to cause nausea and vomiting in higher concentrations .

Especially in the case of multiple pregnancies and diseases of the outer amniotic sac, the hCG level is quite high, so that hyperemesis gravidarum can subsequently occur. Bacterial inflammation of the gastric mucosa can also possibly trigger hyperemesis gravidarum. Stress and tension can also promote hyperemesis gravidarum.

consequences for the mother

Only rarely is the course of hyperemesis gravidarum so severe that it becomes life-threatening. It should be noted that hyperemesis gravidarum is very stressful for the woman. Depression can develop over time; even requests for an abortion are possible.

For this reason it is important that – if a severe form of hyperemesis gravidarum occurs – the pregnant woman receives psychological care . Sometimes a vitamin B deficiency can occur due to frequent vomiting; even disturbances of consciousness are possible. The frequent vomiting rarely leads to injuries to the esophagus or lungs. Due to the altered electrolyte concentration, cardiac arrhythmias may occur.

Consequences for the embryo

The effort involved in throwing up and choking does not harm the unborn. Statistics even indicate that pregnant women who suffer from hyperemesis gravidarum have a lower risk of miscarriage . However, a lack of nutrients can very well ensure that an undersupply occurs and the unborn child does not grow as quickly.

For this reason, the baby may be smaller at birth, but that deficit is usually made up for quickly. The probability that the unborn child – due to hyperemesis gravidarum – will suffer actual damage is theoretically non-existent.


Based on the current symptoms and medical history, the doctor can already suspect that hyperemesis gravidarum is present. The pregnant woman is physically examined, with the main focus being on whether there is dehydration (dry tongue). During the examination, the doctor also checks the woman’s weight.

An ultrasound examination can sometimes confirm that there is a disease of the outer amniotic sac. An examination of the urine provides information about whether the mineral or water balance is disturbed; sometimes the doctor also recognizes whether the metabolism is impaired. The doctor also checks the urine for weight, quantity and ingredients (acetone and electrolytes).

If the hyperemesis gravidarum is very stubborn, the doctor checks whether there is sometimes inflammation of the liver ( hepatitis ), inflammation of the gastric mucosa or sometimes inflammation of the pancreas ( pancreatitis ).

What helps with excessive vomiting?

First, there is outpatient therapy. However, if the hyperemesis gravidarum does not improve, the pregnant woman must be hospitalized. Since no actual cause has yet been found as to why hyperemesis gravidarum occurs, the doctor focuses primarily on treating the symptoms.

He tries to improve the metabolic situation so that the symptoms can be alleviated. In outpatient treatment, attention is paid first to nutrition. The pregnant woman should preferably eat low-fat and high-carbohydrate food. It is important that several meals are taken throughout the day.

Breakfast should already be taken in bed (advisable: rusks, toast and tea). Striking and intensely smelling dishes should be avoided. The smell of meat in particular can promote nausea. The pregnant woman should drink enough liquid between meals. In many cases, a change in diet is enough to alleviate the symptoms.

When should you go to the hospital?

If there is advanced hyperemesis gravidarum, the pregnant woman sometimes has to be admitted to the hospital. Especially if the doctor has found an electrolyte disorder. At the beginning of inpatient admission, food intake is completely stopped. The pregnant woman receives infusions so that she is supplied with enough liquid consisting of carbohydrates and amino acids .Vitamins are also administered; Antiemetics can also be prescribed if needed. Only when the pregnant woman throws up rarely (no more than three times a day) can she sometimes try to start eating again. During the hospital stay, pregnant women are also given psychological care and support.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.