Hyperemesis Gravidarum (HG) is an extreme form of sickness during pregnancy.

It affects approximately 1-3% of women who experience pregnancy sickness and is incredibly debilitating for those affected. Up to 30,000 pregnancies per year in the UK are affected by HG. 

Women with HG often experience severe nausea and vomiting multiple times a day, making it difficult or impossible to keep food or drink down. This condition often requires hospital treatment due to the severity of the symptoms.

Common pregnancy sickness vs. HG

Most pregnant women, up to 90%, experience some level of sickness during pregnancy, typically improving or resolving by around 14 weeks. However, HG is much more severe, with relentless and excessive nausea and vomiting far beyond what's considered normal. Symptoms of HG peak at 9-13 weeks and may persist until the baby is born, although some improvement can occur around 20 weeks.

Symptoms of Hyperemesis Gravidarum

• Prolonged and severe nausea and vomiting: Some women report vomiting up to 50 times a day.
• Dehydration: This occurs when you can't keep fluids down. If you're drinking less than 500ml a day, call your maternity unit.
• Ketosis: A serious condition resulting from the build-up of acidic chemicals in the blood and urine. Ketones are produced when the body breaks down fat instead of glucose for energy.
• Weight loss: Due to the inability to keep food down. This can be rapid and severe.
• Low blood pressure when standing: This can lead to dizziness and fainting.

You must seek medical advice if you're unable to keep any food or fluids down, as dehydration can happen rapidly.

What causes Hyperemesis Gravidarum?

The exact cause of HG is unknown, but it's believed to be related to the hormonal changes during pregnancy. There's evidence suggesting that HG can run in families, so if your mother or sister had HG, you might be more likely to experience it too. Additionally, if you had HG in a previous pregnancy, you're at a higher risk of having it again in subsequent pregnancies.

How do they assess the severity of sickness?

The Pregnancy-Unique Quantification of Emesis (or PUQE score for short) is an assessment tool which healthcare professionals could use to help them to determine the severity of your symptoms and where you may be sitting on the pregnancy sickness spectrum. Each question has a score between 1 – 5 depending on your answer, and the total number scored can be used to get a better understanding of where you may be on the pregnancy sickness spectrum.

There are other things you should take into consideration too:

• Are your symptoms affecting your ability to eat and drink?
• Have you lost weight since you became pregnant? If so how much?
• Are your symptoms making it hard to function normally?
• Are you having to take time off from work?
• Are you struggling to do day to day normal activities or even just to get out of bed?

If you answer yes to one or more of these questions, then you need to call you maternity unit for advice and support.

Baby Movements

Monitoring your baby’s movements is an important part of keeping track of their wellbeing, especially if you have severe pregnancy sickness or other pregnancy condition. If you think your baby’s movements have slowed down or stopped, contact your maternity unit immediately. Midwives and doctors are there to help you - 24 hours a day, 7 days a week.

More Resources

Pregnancy Sickness Support

NHS Website

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