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If HG continued past mid-pregnancy, did you experience complications during delivery related to your poor health such as a strained ligaments/joints, pelvic floor damage, prolonged or weak pushing, fainting, low blood pressure, low pain tolerance, forceps/assisted delivery, broken bones, nerve damage, low amniotic fluid, fetal problems due to difficult delivery, etc.?


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Signs & Symptoms

Symptoms usually begin around week 4-6 and peak between 9-13 weeks, however, some women report changes beginning just a few days following conception. Early changes may include changes in taste or smell perception, nausea, vomiting, and excessive sleepiness. Often there is resolution or at least significant improvement somewhere around 14-20 weeks, though at least 10-20% of hyperemetic women will continue to have significant nausea/vomiting until late pregnancy or delivery.

Treatment (antiemetics, nutrition) should be weaned very slowly after the mother is asymptomatic for two or more weeks to prevent relapse or worsening of symptoms.

Physical Signs & Symptoms

Diagnostic Signs & Symptoms

  • Food aversions and intolerance
  • Anorexia
  • Dizziness/fainting
  • Nausea/vomiting at sight/smell/thought of food
  • Hypersensitive gag reflex
  • Inability to remain in upright position
  • Dehydration
  • Pale, waxy, dry and sometimes yellow skin
  • Hemorrhages in the retina
  • Headache, confusion or lethargy
  • Excessive salivation (sialorrhea or ptyalism)
  • Vomiting, first of mucus, then of bile and finally of blood
  • Constipation
  • Gustatory hypersensitivity to texture
  • Hyperolfaction
  • Dysgeusia
  • Dry, furry tongue
  • Loss of skin elasticity
  • Jaundice
  • Pale, waxy, dry and sometimes yellow skin
  • Body odor (from rapid fat loss & ketosis)
  • Extreme fatigue/malaise
  • Motion sickness
  • Decreased gustatory (taste) discernment
  • Headache, confusion or lethargy
  • Sleep disturbance
  • Anxiety (secondary)
  • Irritability
  • Tearfulness
  • Depression (secondary)
  • Excessive thirst
  • Postural hypotension
  • Tachycardia
  • Fever
  • Ketonuria, ketonemia
  • Neurological dysfunction
  • Vitamin/electrolyte deficiency
  • Anemia
  • Elevated liver enzymes
  • Elevated serum amylase
  • Rapid weight loss of 5% or more over pre pregnancy weight
  • Gall bladder dysfunction
  • Dehydration/hypovolemia
  • Oliguria
  • Elevation of serum transaminase
  • Hyperparathyroidism


Adapted from: www.rarediseases.org

Nausea and vomiting of pregnancy. Broussard CN, Richter JE. Gastroenterology Clinics of North America. 1998 Mar;27(1):123-51

Bianchi AL, Grelot L, Miller AD, King GL, eds. Mechanisms and Control of Emesis. London, England: INSERM/ John Libbey Eurotext Ltd; 1992:185-194.

Stander HJ. Textbook of obstetrics, designed for the use of students and practitioners. New York, D. Appleton-Century Co; 1945.

O'Grady JP, Cohen LM. Emesis and hyperemesis gravidarum. IN Obstetric Syndromes & Conditions. O'Grady JP and BurkmanRT, eds. New York: Parthenon Pub. Group; 1998.

Updated on: Aug. 17, 2019

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