Discharge Instructions - Hyperemesis Gravidarum

As discussed in the Emergency Department prior to discharge, you have been diagnosed with hyperemesis gravidarum.  Hyperemesis gravidarum is a condition that causes frequent vomiting (throwing up) in pregnant women.  It is like morning sickness, except the symptoms are much more severe.

Morning sickness is the nausea and vomiting that many women have during pregnancy.  Even though it is called "morning" sickness, symptoms can happen any time of day.

Women with hyperemesis gravidarum vomit every day, often many times a day.  Women can lose weight and get dehydrated because they are vomiting so much.

Symptoms of dehydration include:

    -Urinating less often than usual

    -Having dark yellow urine

    -Feeling dizzy when standing up

    -Weight loss

Symptoms of hyperemesis gravidarum usually start during the first 2 to 3 months of pregnancy.  Most women feel better by the middle of their pregnancy.  But some women feel sick until late in the pregnancy.

To feel better, you can try the following:

-Eat as soon as you feel hungry, or even before you feel hungry.

-Snack often and eat small meals.  The best foods to eat are high in protein or carbohydrates, and low in fat.  These include crackers, bread, pretzels, nuts, and low-fat yogurt.

-Avoid foods that are spicy, greasy, or acidic (such as oranges).

-Drink cold, clear beverages, such as sports drinks and ginger ale.  Avoid coffee.  Also, try to drink between meals, rather than with a meal.

-Suck on popsicles or ginger-flavored lollipops.

-Brush your teeth right after you eat.

-Avoid lying down right after you eat.

-Take your vitamins at bedtime with a snack, not in the morning

-Avoid things in your environment that upset your stomach, such as stuffy rooms, strong smells, hot places, or loud noises.

-Have someone make your meals for you.

-Wear "acupressure" bands on your wrists.  These are special bands that can help with morning or motion sickness.

Treatment depends on how severe your symptoms are.  If you are dehydrated or have lost a lot of weight, you will probably need to be treated in the hospital with:

    -Fluids that go into your vein through a tube called an "IV"

    -Medicines to help stop your nausea and vomiting

If this treatment doesn't work, your doctor can feed you through a tube that goes in your nose and down into your stomach or through a vein.

Babies born to women with hyperemesis gravidarum for the entire pregnancy are a little more likely to be smaller than average.  But otherwise, the condition doesn't seem to cause problems.  Taking medicines for nausea and vomiting during the pregnancy should not affect the baby either since your doctor will select medications that are safe in pregnancy.

Return to the Emergency Department for inability to tolerate fluids by mouth despite treatment, abdominal or pelvic pain, vaginal bleeding, not passing urine for more than 6 hours despite multiple attempts, or any new or concerning symptoms.