Pregnancy Spotlight: Extreme Morning Sickness

Every day, our nurses and attorneys receive calls from expectant mothers with concerns about symptoms they’re experiencing during their pregnancy. They’re curious if their symptoms are normal, and they wonder what their next steps should be. Patients should always visit a medical professional with concerns and receive appropriate care for maternal-fetal conditions and illnesses that can arise during pregnancy.

We started the Pregnancy Spotlight Series, a monthly column that highlights specific pregnancy health concerns, to help educate and empower patients for these medical visits. Today, we’re focusing on Hyperemesis Gravidarum (HG), or extreme morning sickness.


Hyperemesis Gravidarum - Extreme Morning Sickness

What is hyperemesis gravidarum?

70-80% of all pregnant women experience some form of morning sickness during their pregnancy. Hyperemesis Gravidarum is a condition which involves extreme morning sickness, including nausea, vomiting, and weight loss as its major symptoms. It is thought to be a result of high levels of pregnancy hormones, but the exact cause is not known.

What does hyperemesis gravidarum look like?

Pregnancy Spotlight: Hyperemesis Gravidarum - Reiter & Walsh

Hyperemesis gravidarum resembles common morning sickness, but is far more severe and often extends past the first trimester. So how is hyperemesis gravidarum different from regular morning sickness?

The following are symptoms of HG:

  • Nausea that does not subside
  • Severe vomiting
  • Dehydration 
  • Food aversions
  • Anxiety
  • Depression
  • Low blood pressure
  • Rapid heart rate
  • Fainting
  • Confusion
  • Jaundice
  • Loss of 5% or more of pre-pregnancy weight
  • Loss of skin elasticity 
  • Decreased urination
  • Fatigue

How long does HG last?

Many women experience relief between 14 and 20 weeks of pregnancy, but some have symptoms throughout their entire pregnancy.

Are there certain risk factors for HG?

The following groups of women tend to have HG at higher rates:

  • Overweight women
  • Young moms
  • First-time moms
  • Female infant sex
  • Women carrying multiples
  • Women whose mothers had HG
  • Women with endocrine imbalances
  • Women with H. pylori infection
  • Women with extreme emotional stress

How is hyperemesis gravidarum treated?

Treatments for HG include improved hydration, dietary changes, rest, acupressure/acupuncture, and medication, such as antihistamines or drugs to address reflux and nausea. It is very important to consult a doctor about possible interventions. Self-medication is especially risky because certain drugs can endanger a mother and/or affect fetal development.  Severe cases of HG require a hospital visit where the mother receives IV fluids. They may also necessitate the use of feeding tubes, whether inserted through the skin and the stomach wall (percutaneous endoscopic gastrostomy or PEG) or through the nose (nasogastric).

Will hyperemesis harm the baby?

According to the Hyperemesis Education and Research (HER) Foundation, preliminary research has shown that babies born to mothers with HG often have normal outcomes. However, there is a lack of long-term data. More severe cases of HG can put the baby at risk for certain health issues.

Delayed treatment of vomiting can cause dehydration, which can lead to complications for the baby such as:

Will hyperemesis harm me?

Women with HG during pregnancy may deal with health problems such as electrolyte imbalances, depression, and other health concerns. They may also experience symptoms after pregnancy, including muscle weakness, motion sickness, and post-traumatic stress disorder (PTSD).


  1. Hyperemesis Gravidarum: Signs, Symptoms and Treatment
  2. Hyperemesis Gravidarum During Pregnancy
  3. Hyperemesis Gravidarum: Causes, Symptoms, and Diagnosis
  4. Potential Fetal Complications

The information presented above is intended only to be a general educational resource. It is not intended to be (and should not be interpreted as) medical advice. If you have questions about the topic, please consult with a medical professional.