Is It Morning Sickness or Hyperemesis Gravidarum? 8 Signs to Watch For

Updated: Apr. 04, 2017

Some 70 to 80 percent of pregnant women have morning sickness during their first trimester, but some 5 percent get it really bad, vomiting several times a day and getting zero relief from home remedies. Women with this condition, called Hyperemesis Gravidarum, need to seek medical care ASAP to maintain a healthy pregnancy.


Frequent vomiting

Normal morning sickness in pregnancy can cause occasional vomiting, but if you’re tossing your cookies three times a day or more, this may be a sign that it’s not merely morning sickness but actually Hyperemesis Gravidarum. Mild cases can often be treated with dietary changes, rest, and antacids, but more severe cases could merit a trip to the hospital. The main sign is extreme nausea and excessive vomiting, which can cause tears to the esophagus if left unchecked. For treatment, you might need medication such as Diclegis, a time-released pill that’s a combination of an antihistamine and vitamin B6. “This drug has the safest rating of all drugs in pregnancy. It’s taken as two tablets at bedtime because the Doxylamine causes sleepiness; some women find themselves too sleepy so cutting the dose in half helps with this,” says Yvonne Bonn, MD, OBGYN at Providence St. John’s Health Center in Santa Monica, California.



When women are unable to keep foods or liquids down, they’re at risk of developing severe dehydration. Not only does dehydration adversely affect the body’s ability to function—you’ll likely feel fatigue, irritability, headaches, and difficulty focusing, among other symptoms—but it also renders medications ineffective. If dehydration becomes severe, ketosis can result, which causes the body to burn fat. Women with Hyperemesis may need to seek IV fluids in order to restore hydration levels. These are the common signs you may be dehydrated.


Rapid heart rate

Another possible side effect of Hyperemesis Gravidarum is a rapid heart beat. If you are experiencing a rapid heart rate in pregnancy as well as other potential Hyperemesis symptoms, discuss the possibility with your OB. These are the heart-health secrets cardiologists wish you knew.


Low blood pressure

Blood pressure worries in pregnancy are common, but more often than not, doctors are concerned about high blood pressure. Dehydration and malnutrition can lead to low blood pressure, and having steady blood pressure is important for proper development of the placenta. These are the things doctors aren’t telling you about blood pressure.


Weight loss

According to Dr. Bohn, up to a five percent baseline weight loss is an indicator of Hyperemesis Gravidarum. “In very severe cases where there is extreme weight loss, possible preterm birth and low birth weight can result,” she says. Gaining the proper amount of weight is important for healthy mothers and babies.


Extreme fatigue

Women experiencing a typical pregnancy will find themselves more tired than pre-pregnancy, but Hyperemesis taxes the body so severely that extreme fatigue may result. This is also exacerbated by a lack of fuel normally provided by food and water. If you find yourself too exhausted to function, talk to your doctor.


Decreased or darkened urine

Another result of the inability to drink enough water and other liquids is lowered urine output and even darkened urine. Women who experience infrequent urination or darkened urine should have their urine analyzed by their physician who will check for ketones as well as for urea levels, which will show whether or not the mother’s kidneys are properly functioning.


No relief with home remedies

Well-meaning people will often recommend natural remedies such as eating small, frequent meals, sipping carbonated beverages, and using ginger chews for dealing with pregnancy-related nausea. But when the symptoms are more than just morning sickness, when it’s Hyperemesis Gravidarum, these home remedies will be ineffective and often frustrating. After exhausting all of the possibilities without relief, women should speak to their doctor about the possibility that their morning sickness is actually Hyperemesis and seek more effective treatment options such as medication, IV hydration, or even hospitalization when warranted. These are the pregnancy myths you can safely ignore.