Hyperemesis Gravidarum

Basics

Description

  • Hyperemesis gravidarum is the most severe form along the continuum of nausea and vomiting of pregnancy
  • Also known as pernicious vomiting of pregnancy
  • Characterized by unexplained intractable vomiting and dehydration
  • Occurs in 0.3–3% of pregnancies
  • Most common admission reason in 1st trimester
  • 2nd most common admission reason in pregnancy
  • 1–3% of patients with hyperemesis gravidarum require hospitalization
  • Diagnosis of exclusion

Etiology

  • Exact cause unknown
  • Possible causes include the following:
    • Elevated gestational hormone levels of human chorionic gonadotropin (hCG) and/or estradiol
    • Thyrotoxicosis
    • Upper GI motility dysfunction
    • Hepatic abnormalities
    • Autonomic nervous system dysfunction
    • Psychological factors
    • Helicobacter pylori infection
    • Genetic predisposition
    • GDF15, a hormone acting on the brainstem has been implicated

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