Hyperemesis Gravidarum

Zachary H Hicks, DO Reviewed 04/2024

BASICS

Nausea and vomiting in pregnancy is a common condition that affects approximately 70–80% of pregnancies.
Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy that aff...

DIAGNOSIS

Intractable nausea and vomiting in pregnancy leading to dehydration and electrolyte imbalances after the exclusion of other causes of severe nausea and vomiting.

HISTORY

Nausea
Vomiting with r...

TREATMENT

Pyridoxine and doxylamine (pregnancy Category A) are first-line treatments for HG (1)[C]. This is followed by metoclopramide or ondansetron (pregnancy Category B) and then prochlorperazine ...

ONGOING CARE

Approximately 10 percent of patients with HG will be affected throughout the pregnancy.

FOLLOW-UP RECOMMENDATIONS

Overall quality of life and future fertility plans can be impacted by seve...

REFERENCES

Maltepe C, Koren G. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum—a 2013 update. J Popul Ther Clin Pharmacol. 2013; 20(2): e...

ADDITIONAL READING

Boelig R, Barton S, Saccone G, et al. Interventions for treating hyperemesis gravidarum: a Cochrane systematic review and meta-analysis [published onli...

CODES

ICD10

O21.9 Vomiting of pregnancy, unspecified
O21.0 Mild hyperemesis gravidarum
O21.1 Hyperemesis gravidarum with metabolic disturbance
O21.2 Late vomiting of pregnancy
O21.8 Other vomiting complica...

CLINICAL PEARLS

Do not allow patients to become volume depleted. Once this occurs, it is more difficult to treat
Do not be hesitant to use medications for nausea/vomiting, as this may help avoid volume...

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