--- title: 'Managing Hyperemesis Gravidarum in Pregnancy' slug: managing-hyperemesis-gravidarum-pregnancy lifeStage: pregnancy category: Symptoms author: 'Samaira Farid' medicalReviewer: 'Dr Shree Datta, Consultant Obstetrician and Gynaecologist ' reviewerId: 'https://blog.bloume.com/pregnancy/medical-board.md#dr-shree-datta' lastUpdated: '2026-08-29' primarySource: 'RCOG Green-top Guideline No. 69' wordCount: 1079 readTimeInSeconds: 270 --- # Managing Hyperemesis Gravidarum in Pregnancy Hyperemesis gravidarum (HG) is a severe form of pregnancy sickness, with intense, ongoing nausea and vomiting that can last the whole pregnancy. It is different from ordinary morning sickness and affects around 1 to 3 in every 100 pregnant women. Left unmanaged, it can lead to dehydration, significant weight loss, and changes in your salt and mineral balance. This article explains how HG differs from ordinary pregnancy nausea, what practical and medical options can help, and when to contact your GP or midwife. **Q: What is the difference between HG and morning sickness?** A: Ordinary morning sickness brings nausea and sometimes vomiting that usually clears by around 20 weeks. Hyperemesis gravidarum (HG) is more severe, with intense vomiting that can carry on through the whole pregnancy. It can lead to dehydration, significant weight loss, and changes in your salt and mineral balance. HG affects around 1 to 3 in every 100 pregnant women, while up to 80% of pregnancies involve some form of nausea. When the vomiting will not stop, you cannot keep down even a sip of water, and when the exhaustion sets in because your body cannot hold food, what you are dealing with is not ordinary nausea. These are the markers of hyperemesis gravidarum (HG), a distinct and serious condition. HG affects around 1 to 3 in every 100 pregnant women, while milder nausea touches up to 80% of pregnancies. The severity is different, and managing it is different too. ## How HG differs from typical pregnancy sickness Ordinary pregnancy nausea, the kind often called morning sickness, usually eases by around 20 weeks. With HG, your symptoms can carry on for the whole pregnancy. The name morning sickness can feel dismissive once you have lived with HG, partly because the sickness can hit at any hour, day or night. HG usually starts before 16 weeks, with severe nausea and vomiting, trouble eating or drinking normally, and a real impact on getting through your day. It can lead to dehydration, weight loss of more than 5% of your pre-pregnancy weight, and changes in your body's salt and mineral balance (electrolytes). These are signs to talk through with your GP or midwife, who can assess your symptoms properly. ## Practical management and dietary adjustments If your symptoms sit at the milder end, a few changes to food and routine can take the edge off. Eating small amounts often, like a dry biscuit before you get up, can settle the nausea. You might also find it helps to skip greasy or spicy foods, rest when you can, and keep rooms aired so strong smells do not build up. Sipping fluids little and often tends to go down more easily than drinking a lot at once. Ginger is often suggested for standard pregnancy sickness, but it is not recommended for Hyperemesis Gravidarum (HG). Current clinical guidelines clarify that while ginger and acupressure may offer relief for mild-to-moderate nausea, there is no evidence that they work for HG. Trying to manage HG with ginger is ineffective and can cause unpleasant side effects, such as stomach irritation and reflux. For HG, medical treatment from your GP or midwife, including anti-sickness medication, is essential alongside any food and fluid adjustments. ## Medication options your doctor may consider Several anti-sickness medicines, also called anti-emetics, are generally considered safe to use in pregnancy. You may need to try different types, or a combination, before you find what works best for you. The first medicines your doctor may prescribe include antihistamines such as cyclizine, and prochlorperazine is sometimes used too. The only medicine specifically licensed for nausea and vomiting in pregnancy in the UK is Xonvea, a combination of doxylamine and pyridoxine, though it is not available everywhere. If those do not give you enough relief, second medicines such as metoclopramide or ondansetron may be prescribed. Current guidance says ondansetron is safe and effective when weighed up properly, and that it should not be ruled out once first-line treatments have not worked. For the most severe cases that do not respond to other treatments, corticosteroids may be considered under specialist care. > **INFO**: Everything listed here is for information only. Any decision about starting, changing, or stopping medication in pregnancy is one to make with your GP, midwife, or specialist. ## When to contact your GP or midwife Call your GP or midwife early if you are being sick often and cannot keep food or drink down. Getting support quickly can help stop problems like dehydration and significant weight loss from building. Some signs need prompt medical attention. These include long-lasting, severe vomiting, weight loss you can notice, and signs of dehydration, such as feeling very thirsty, unusually tired or dizzy, passing little urine, or seeing that your urine is dark and strong-smelling. ## Hospital treatment for severe HG When your symptoms cannot be managed at home, you may need to be admitted to hospital. This is supportive care meant to steady things. Treatment usually means fluids given through a drip to top up your hydration, and anti-sickness medicines given through a drip or injection. You will also be offered thiamine (vitamin B1) and treatment to help prevent blood clots while you are there. ## Emotional impact and finding support HG can be hard emotionally as well as physically. If your mental health is struggling alongside the physical symptoms, it is worth raising this with your GP or midwife. Pregnancy Sickness Support is a UK charity with a helpline, and a way to connect with others who have been through HG. You can reach them at pregnancysicknesssupport.org.uk. --- **Q: What is the difference between HG and morning sickness?** Ordinary morning sickness brings nausea and sometimes vomiting that usually clears by around 20 weeks. Hyperemesis gravidarum (HG) is more severe, with intense vomiting that can carry on through the whole pregnancy. It can lead to dehydration, significant weight loss, and changes in your salt and mineral balance. HG affects around 1 to 3 in every 100 pregnant women, while up to 80% of pregnancies involve some form of nausea. **Q: Does ginger help with HG?** Ginger comes up a lot for pregnancy sickness in general, but for HG it is not recommended. Current guidance advises against it because it often does not work and can cause grim side effects. If your symptoms are severe, it is better to talk to your GP or midwife about medical treatment options. **Q: When should you go to hospital with HG?** Call your GP or midwife promptly if you cannot keep food or drink down. You may need hospital care when symptoms are severe and cannot be managed at home. Signs that need urgent attention include long-lasting, severe vomiting, weight loss you can notice, and signs of dehydration, such as passing little or dark urine, dizziness, or extreme tiredness. In hospital, treatment includes fluids through a drip, anti-sickness medicines, thiamine, and care to help prevent blood clots. **Q: What medicines are used to treat HG in pregnancy?** Several anti-sickness medicines, also called anti-emetics, are generally considered safe to use in pregnancy. The first ones your doctor may prescribe include antihistamines such as cyclizine, and prochlorperazine. If these do not help, second medicines such as metoclopramide or ondansetron may be considered. The only medicine specifically licensed for nausea and vomiting in pregnancy in the UK is Xonvea, a combination of doxylamine and pyridoxine, though it is not available everywhere. Any decision about medication is one to make with your doctor or midwife. ### Clinical Sources - [RCOG Green-top Guideline No. 69](https://www.rcog.org.uk/media/y3fen1x1/gtg69-hyperemesis.pdf) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [ouh.nhs.uk](https://www.ouh.nhs.uk/media/jponwt12/104055hyperemesis.pdf) - [pregnancysicknesssupport.org.uk](https://pregnancysicknesssupport.org.uk/healthcare-professionals/hg-guidelines/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [chelwest.nhs.uk](https://www.chelwest.nhs.uk/your-visit/patient-leaflets/womens-services/nausea-and-vomiting-in-pregnancy-hyperemesis-gravidarum) - [Pregnancy sickness (nausea and vomiting of pregnancy and hyperemesis gravidarum)](https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pregnancy-sickness-nausea-and-vomiting-of-pregnancy-and-hyperemesis-gravidarum/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) - [Severe vomiting in pregnancy](https://www.nhs.uk/pregnancy/complications/severe-vomiting/) --- Reviewed by Dr Shree Datta, Consultant Obstetrician and Gynaecologist | [Medical Board](https://blog.bloume.com/pregnancy/medical-board.md) | August 2026