Morning Sickness and Hyperemesis Gravidarum (HG)

Published 22nd April 2022 | Dr Ujwala Parashar

Pregnancy is a time that holds many special memories as well as some wonderful moments. But for many pregnant women (around 70%) the first trimester of pregnancy also includes morning sickness. For most women while morning is debilitating, it doesn’t harm them or their unborn child. In rarer instances, (around 1 in 1,000 women) have severe morning sickness. This is a serious condition known as hyperemesis gravidarum (HG) that can last the entire pregnancy and poses significant health risks for the mother and the unborn baby. This article outlines the differences between morning sickness and hyperemesis gravidarum and provides an understanding into each condition as well as management and treatment insights.

What is hyperemesis gravidarum (HG)?

Hyperemesis gravidarum or HG affects around 1 in 1,000 pregnant women. HG symptoms are more severe than morning sickness and women with HG may suffer symptoms into their second trimester or even for the duration of their pregnancy. It typically includes nausea that doesn’t go away as well as repeated vomiting leading to severe dehydration. HG is extremely debilitating and if not properly managed is potentially life threatening for the mother and her baby.
What are the symptoms of hyperemesis gravidarum (HG)?
Women suffering from HG have symptoms that usually present at around 6 weeks of the pregnancy. HG symptoms can include: 
  • Repeated vomiting (more than 3 – 4 times per day)
  • Fatigue lasting for weeks - or even months
  • Loss of appetite
  • Feeling dizzy or lightheaded
  • Inability to work or perform daily activities
  • Loss of body weight due to nausea and vomiting
  • Headaches, confusion, jaundice
  • Low blood pressure
  • Fast pulse rate
  • The body going into ketosis
  • Dehydration

What are the possible complications of untreated hyperemesis gravidarum (HG)?

If left undiagnosed and untreated, complications of HG can include:
  • Malnourishment of the unborn baby
  • Extreme depression and anxiety
  • Electrolyte imbalances
  • Excessive strain placed on vital organs such as the liver, heart, kidneys, and brain

Who is at risk of developing HG?

Some known factors that increase the risk of a pregnant woman developing HG include:
  • A previous pregnancy with HG, or a family history of HG
  • Being pregnant with a multiple pregnancy (twins or more)
  • Being a first time mum
  • Being overweight
  • Trophoblastic disease

How is HG diagnosed?

To determine if you are suffering from hyperemesis gravidarum, Dr Parashar will start by taking a full medical history and a discussion of your symptoms and will check for common indicators such as abnormally low blood pressure or a fast pulse.
She may also arrange for:
  • Blood and urine samples to check if you are dehydrated 
  • An ultrasound to check for a multiple pregnancy or other problems
  • Other investigations to rule out other causes of your nausea or vomiting

How is HG managed and treated?

Dr Parashar determines the treatment for HG based on the severity of your symptoms. This can involve lifestyle modifications as well as the use of natural nausea prevention methods including:
  • A change in diet and rest
  • Taking vitamin B-6 or ginger
  • Eating smaller, more frequent meals
  • Eating dry foods such as crackers
  • Drinking lots of fluids to maintain hydration

What if the HG symptoms are more severe?

Severe cases of HG may require hospitalisation for the administration of intravenous liquids and nutrition, and in some instances, Dr Parashar may prescribe medication if the vomiting is becoming dangerous for you or your baby.
When should you call Dr Parashar?
If you are pregnant and suffering from repeated daily vomiting, you may have HG and should arrange for a consultation as early diagnosis and management can help prevent an increase in severity. As a guide, arrange for a consultation with Dr Parsahar if:
  • You have nausea that lasts all day and prevents you from eating and drinking
  • You vomit more than three times per day
  • Your vomit has blood in it or is brown in colour
  • You are losing weight
  • You feel dizzy or have fainted
  • You have a fast pulse rate
  • You are producing little or no urine

Call to schedule your consultation with Dr Parashar on 1300 811 827, and please let our team know about your symptoms when you call so we are able to prioritise your appointment time.

Dr Ujwala Parashar, Obstetrician & Gynaecologist

Sam Samant

Dr Ujwala Parashar is a highly trained female obstetrician and gynaecologist with over 15 years of professional experience and training, practicing in Sydney's North Shore and Barangaroo. If you would like more information on conception, or if you are seeking obstetric options and advice, please contact us or call 1300 811 827 to arrange a consultation with her.