Severe vomiting in pregnancy
Nausea and some vomiting are common in early pregnancy, but hyperemesis gravidarum is much more severe: the woman vomits many times a day and cannot keep food or fluids down. It can cause dehydration and weight loss and usually needs medical treatment. It often starts before 9 weeks and gets better by 16 to 20 weeks, but can last longer. With treatment the baby is usually fine.
Symptoms
- Vomiting many times a day
- Not able to keep food or drinks down for 24 hours
- Weight loss
- Dark urine or passing very little urine
- Dizziness or fainting when standing up
- Dry mouth and severe tiredness
Causes
- High levels of pregnancy hormone (hCG) in early pregnancy
- Twins or more
- Severe vomiting in a previous pregnancy, or in your mother or sister
- First pregnancy
- Rarely a molar pregnancy — an ultrasound can check this
Prevention
- It cannot always be prevented
- Eat small, dry snacks often (dry naan, plain biscuits) instead of large meals
- Sip water, clear soup or ORS often during the day
- Avoid smells and foods that make the nausea worse
- Rest, and get treatment early before dehydration becomes severe
Treatment
- Small frequent meals and sips of fluid
- Anti-sickness medicines that are safe in pregnancy, prescribed by a doctor
- IV fluids (a drip) in hospital if you are dehydrated
- Vitamins such as thiamine (vitamin B1) if vomiting continues
- Checks of weight, urine and blood salts
- Do not take any medicine for vomiting without asking a doctor
Common questions
Will the vomiting harm my baby?
Mild morning sickness does not harm the baby. Severe vomiting can harm you and the baby if dehydration and weight loss are not treated, so get help early — with treatment most babies are healthy.
When will it stop?
For most women it gets much better between 16 and 20 weeks. For a few women it continues longer, so stay in touch with your doctor.