Severe Morning Sickness (Hyperemesis Gravidarum)

Upset stomach (nausea) and vomiting are common in pregnancy. It is often called morning sickness even though it can happen at any time of day. Severe nausea and vomiting that continue for a long time is not normal. This is known as hyperemesis gravidarum. This condition may cause too much fluid loss (dehydration) and excess weight loss. This can be dangerous for you and your baby. If you have been diagnosed with this, it is important that your healthcare provider treats the condition as soon as possible. This is done to keep you and your baby safe, and so that you get some relief from the symptoms. 

Symptoms of severe morning sickness

Call your healthcare provider right away if you have symptoms like these:

• Unable to keep down food or liquids

• Severe nausea and vomiting beyond the first few months of pregnancy

• Urine that is dark and in small amounts 

• Dizziness or fainting

• Headaches

• Confusion

• Rapid heart rate

What causes severe morning sickness?

Morning sickness may be caused by an increase in some hormone levels. It is not clear why it's more severe in some people. It may be more likely if you are carrying twins or more. You may need some tests. These are to check for other health conditions that can cause severe nausea and vomiting.

Getting relief from morning sickness

To help reduce nausea:

• Eat small amounts of food often. An empty stomach can make nausea worse.

• Choose dry foods, such as crackers.

• Try sipping cold, clear drinks.

• Take ginger, if your healthcare provider advises.

• Your provider may advise that you try vitamin B-6 and medicines called doxylamine and pyridoxine. These can help to ease the nausea.

• Try acupuncture. In some cases, it can help manage nausea.

Treating severe morning sickness

The focus of treatment for severe morning sickness is to:

• Ease your symptoms

• Prevent weight loss

• Prevent too much fluid loss (dehydration)

If you are dehydrated or losing weight, you may need to be in the hospital for a short time. You will have IV (intravenous) fluids. This is to replace lost fluids. You may be given medicines that ease nausea. In very severe cases, you may need more time in the hospital. You may need IV nutrition or tube feeding. If you need these, your healthcare provider will tell you more.

Recovery and follow-up

With treatment, severe morning sickness can be managed. Follow up with your healthcare provider. They want to make sure you are keeping down food and fluids and check that you're gaining a healthy amount of weight.

When to get medical care

Call your healthcare provider or get medical care right away if you have any of these:

• Signs of dehydration (see below)

• Weight loss

• Dizziness or fainting

• Racing or pounding heart

• Blood in your vomit

Signs of dehydration include:

• Extreme thirst

• Headache

• Small amounts of urine

• Very dark urine

• A dry, sticky mouth