Hyperemesis Gravidarum (HG) - Patient Education Home

Hyperemesis Gravidarum (HG)
Many women have some nausea and vomiting during the first 3 months of
pregnancy. It is often called morning sickness, but it can occur at any time
of the day.
Some women can develop a condition called Hyperemesis Gravidarum
(HG). This is when the vomiting becomes so frequent and severe that the
woman loses a large amount of weight. It can lead to dehydration, or not
enough water in the body. This makes it hard for your body to get enough
nutrition. If HG becomes severe, it can be dangerous for mother and baby.
Signs of HG
Call your doctor if you have these signs. They are more than morning
sickness:
• Vomiting more than 6 times a day
• Weight loss of 5 pounds or more
• Not able to keep any food or fluids down for 24 hours or longer
• Urine is dark yellow or not able to urinate for long periods
• You have abdominal pain, fever, or have weakness
• Feel faint
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Treatment for HG
Your doctor may try several treatments to help your condition:
Dietary Changes
• Eat small meals often to avoid an empty stomach. Eat dry crackers,
toast, or cereal before getting out of bed or when feeling queasy or
nauseated.
• Wait at least 15 to 30 minutes after eating before drinking fluids. Take
sips of clear liquids only. Examples of clear liquids are clear fruit juices
(apple, pear, white grape), weak tea, soft drinks like Sprite, 7-UP or
ginger ale, and broth. Try low sugar or no sugar type drinks such as
Gatorade or Powerade Zero.
• Eat foods that are easy to digest such as bread, toast, plain crackers, dry
Cheerios or other dry, low sugar cereals, or bagels. Try gluten-free
options, such as Rice Chex.
• Avoid greasy or spicy foods. Try bland foods until nausea gets better.
• Avoid strong food smells that can trigger nausea.
• After 2 or 3 days with little or no vomiting, follow the Hyperemesis
Diet (Dry Diet) handout for more food choices.
Food Diary
Keep a diary of when vomiting occurs, such as certain foods, odors,
activities, or places. The goal is to find anything that triggers the nausea.
Share this information with your doctor and care team.
Medical Treatment
• If severe dehydration occurs, intravenous fluids (by vein) may need to
be given through a tube into your vein called an IV.
• Most doctors avoid giving medicines during pregnancy. However, in
this situation, the risk of using medicines is less than the risk of poor
nutrition and weight loss from HG. These medicines may be used to
help you. Please talk with your doctor, nurse, and pharmacists about
questions you may have using these medicines.

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Over-the-counter medicines (purchased without a prescription): For
all medicines, take as directed. Do not take more than the dose
listed on the package.
• Medicines for nausea and motion sickness (Antihistamines):
Doxylamine (Unisom ® ) or Diphenhydramine (Benadryl ® )
Dimenhydrinate (Dramamine ® )
Meclizine (Bonine ® , Antivert ® )
• Vitamins:
Pyridoxime (Vitamin B6)
Prenatal or multivitamin
Calcium supplement
Prescription Medicines: For all medicines, take as directed. Do not
take more than the dose listed on the package or as prescribed.
• Medicines to treat nausea and vomiting (Phenothiazines):
Prochlorperazine (Compazine ® )
Promethazine (Phenergan ® )
• Medicines to increase movement of food from the stomach to the
intestines:
Metoclopramide (Reglan ® )
• Medicines to decrease stomach acid production and treat reflux, or
movement of stomach contents backwards into esophagus:
Ranitidine (Zantac ® )
Famotidine (Pepcid ® )
Pantoprazole (Protonix ® )
Lansoprazole (Prevacid ® )
Omeprazole (Prilosec ® )
Medicine pumps: If you have been hospitalized for HG, you may
have a pump for one week to one month after discharge.
• You may have care from a home health nurse to monitor your condition.
• You may have follow up phone calls for your care.
Talk to your doctor or others on your health care team if you have
questions. You may request more written information from the
Library for Health Information at (614) 293-3707 or email: healthinfo@osu.edu.