Hyperemesis Gravidarum

Lorena Likaj, MPH, MD and Robert A. Monteleone, M.D. Reviewed 06/2022

BASICS

Nausea and vomiting in pregnancy is a common condition that affects approximately 70 to 80% of pregnancies.
A more severe form of nausea and vomiting, hyperemesis gravidarum, affects 0.5 to 2% o...

DIAGNOSIS

The definition of hyperemesis gravidarum varies but often includes intractable nausea and vomiting in pregnancy, signs of dehydration, electrolyte imbalances after the exclusion of other cau...

TREATMENT

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

ONGOING CARE

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

FOLLOW-UP RECOMMENDATIONS

Overall quality of life and future fertility plans can...

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

Abas MN, Tan PC, Azmi N, et al. Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet Gynecol. ...

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 interrupt the process.
Do not be hesitant to use medications to assist the patient, as this ma...

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