Most people are familiar with the idea of morning sickness, which can affect people in the early stages of pregnancy. This feeling of queasiness with some occasional vomiting is relatively common, impacting about 70 percent of pregnancies, but typically ends after the first trimester. Morning sickness that becomes extreme and impacts daily life is known as hyperemesis gravidarum, or simply hyperemesis.

What are the symptoms of hyperemesis?

As with morning sickness, people experiencing hyperemesis feel nauseous and may vomit. In patients with hyperemesis, the nausea and vomiting may be persistent and impact their daily lives. They may also experience weight loss and electrolyte imbalance because of the inability to keep food down.

How long does hyperemesis last in pregnancy?

For most people, nausea and vomiting starts to improve by 10 to 12 weeks. Unfortunately, a smaller number of people will develop hyperemesis and have symptoms throughout their entire pregnancy. Hyperemesis will typically ebb and flow with good and bad days.

How do you treat hyperemesis?

We treat hyperemesis with medications to manage nausea, often requiring more than one anti-nausea medication. For people who are not able to take in enough fluids by mouth, we will use IV fluids for hydration. Very rarely do we need to give nutrition through an IV. IV nutrition would happen only in quite severe cases in a hospital setting but is an option for management if needed.

Commonly associated issues include acid reflux and constipation. We use medications to manage those issues as well, which can improve the nausea.

Can hyperemesis cause miscarriage?

Thankfully, no. Nausea and vomiting in pregnancy are actually associated with a lower rate of miscarriage. As long as hyperemesis is managed appropriately, it is not associated with significant risks to the pregnancy.

Is hyperemesis a high-risk pregnancy?

Hyperemesis is not a high-risk pregnancy condition. As long as it is properly managed, there are no risks to the baby while having hyperemesis during pregnancy, nor are there any long-term risks seen in babies born to parents with hyperemesis in pregnancy. However, it does often lead to many more office visits for symptom management and may result in being admitted to the hospital for a period of the pregnancy. Typically, hospital admissions are short and needed for hydration and adjusting medications. People with hyperemesis in one pregnancy have a higher chance of having hyperemesis in future pregnancies.

People should be aware that there is an association between hyperemesis and perinatal depression as hyperemesis can make for a challenging pregnancy. If you are experiencing depressive symptoms, you should seek care from a behavioral health provider.

At the Lifespan Physician Group Obstetrics and Gynecology service, we are committed to providing exceptional care for women based on the latest research, technological advances and holistic approaches. Visit the Lifespan Physician Group Obstetrics and Gynecology website or call 401-606-3000 for more information.

Jessica Torres

Jessica Torres, MD, FACOG

Dr. Jessica Torres, is an obstetrician and gynecologist at Lifespan Physician Group, Obstetrics and Gynecology. Her areas of interest include abnormal uterine bleeding, holistic women's health, high-risk obstetrics, and the history of medicine.