Severe Morning Sickness (Hyperemesis Gravidarum)

Upset stomach (nausea) and vomiting are common during pregnancy. It is often called morning sickness. But it can happen at any time of day. But severe nausea and vomiting that doesn’t let up is not normal. Fluid loss (dehydration) and weight loss can result. This can be dangerous for the mother and baby. Severe nausea and vomiting during pregnancy (hyperemesis gravidarum) results in significant weight loss. If you have it, your healthcare provider can take steps to keep you and your baby safe. He or she can also help you find relief. 

What are the symptoms of severe morning sickness?

Call your healthcare provider right away if you think that you may have severe morning sickness. The symptoms include:

  • Unable to keep down liquids

  • Severe nausea that lasts beyond the first few months

  • Unable to empty the bladder 

  • Urine that is dark and concentrated 

  • Fainting spells

What causes severe morning sickness?

Nausea and vomiting during pregnancy are thought to be caused by an increase in certain hormone levels. It is not clear what causes severe morning sickness. But it may be more likely in women carrying twins or more. Your healthcare provider will do some tests to rule out certain health conditions that may lead to severe nausea and vomiting.

Getting relief from morning sickness

To help combat nausea, eat small amounts often. This helps prevent the stomach from being empty, which can make nausea worse. Choose dry foods such as crackers. Try sipping cold, clear drinks. And ask your healthcare provider about taking vitamin B-6 or ginger to help ease nausea. Your provider may advise that you try vitamin B-6 and a medicine called doxylamine to ease the nausea. In some cases, alternative treatments such as acupuncture work well in helping to manage nausea during pregnancy.

Treating severe morning sickness

The focus of treatment for severe morning sickness is to ease symptoms and prevent weight loss and dehydration. If you are dehydrated or losing weight, steps are needed to protect you and your baby. You will most likely be admitted to the hospital for at least a short time. There, you can be given IV (intravenous) fluids to rehydrate you. You may also be prescribed medicines that ease nausea. In very severe cases, a longer hospitalization may be needed. IV nutrition or tube feeding will then be used. If this is needed, your healthcare provider can tell you more.

Recovery and follow-up

With treatment, severe morning sickness can be managed. Follow up with your healthcare provider to be sure you are keeping down fluids and gaining a healthy amount of weight.

When to get medical care

Call your healthcare provider right away if you have any of these:

  • Signs of dehydration, including extreme thirst, headache, little urine, very dark urine, or a dry, sticky mouth.

  • Weight loss

  • Dizziness or fainting

  • Racing or pounding heart

  • Blood in your vomit