Hyperemesis gravidarum
Hyperemesis gravidarum is severe nausea and vomiting of early pregnancy that prevents normal eating and drinking and limits daily function; assess clinically for dehydration, weight loss, electrolyte disturbance and alternative diagnoses, then escalate antiemetics and fluids through community, ambulatory or inpatient care.
Definition
Hyperemesis gravidarum is severe nausea and/or vomiting beginning in early pregnancy that prevents normal eating and drinking and strongly limits daily activities; signs of dehydration, weight loss, nutritional compromise or complications may accompany the syndrome.
First principles
HG is a clinical syndrome, not a urine-ketone diagnosis
The 2024 RCOG guideline describes HG as early-pregnancy nausea and/or vomiting severe enough to prevent normal eating and drinking and strongly limit daily activities, with dehydration contributing to the diagnosis. Severity is judged from the history, examination, nutritional and functional impact and validated tools such as PUQE or HELP; ketonuria is not an indicator of dehydration or HG severity and should not drive monitoring or admission by itself.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.