Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy that leads to:

Weight loss >5% of pre-pregnancy weight.
Electrolyte imbalance (Hypokalemia, Hyponatremia).
Dehydration & Ketosis.

Distinction from Morning Sickness:

Morning sickness: Mild nausea & vomiting, resolves by 12–16 weeks.
Hyperemesis gravidarum: Severe, persistent vomiting requiring medical intervention.

2. Causes & Risk Factors

Hormonal Factors:

↑ hCG levels (Common in multiple pregnancy, molar pregnancy).
↑ Estrogen & Progesterone (Slows gastric motility).

Predisposing Factors:

Multiple Pregnancy (Twins, Triplets).
Hydatidiform Mole (High hCG levels).
Personal/Family History of HG.
Gastrointestinal Disorders (GERD, H. pylori infection).

3. Clinical Features

Persistent nausea & vomiting (Not relieved by usual measures).
Weight loss >5% of body weight.
Signs of Dehydration:

Dry mucous membranes, Tachycardia, Hypotension.

Electrolyte Imbalance:

Hypokalemia (Muscle weakness, Arrhythmias).
Metabolic Alkalosis (From vomiting) → Later Acidosis (If severe starvation).

Complications of Untreated HG:

Wernicke’s Encephalopathy (Due to Thiamine Deficiency):

Triad: Ophthalmoplegia, Ataxia, Confusion.

Small for Gestational Age (SGA) Baby.
Preterm Birth.

4. Diagnosis of Hyperemesis Gravidarum

Clinical Diagnosis:

Excessive vomiting, Weight loss, Dehydration.

Investigations:

Urine Ketones → (+) in starvation & dehydration.
Serum Electrolytes → Hypokalemia, Hyponatremia.
Liver Function Tests (LFTs) → Mild elevation of AST, ALT.
Thyroid Function Tests (TFTs) → ↑ T3/T4 due to hCG stimulation (Transient hyperthyroidism).
Ultrasound → To rule out molar pregnancy, multiple pregnancy.

5. Management of Hyperemesis Gravidarum

A. First-Line (Mild to Moderate Cases, Outpatient Management)

Lifestyle & Dietary Advice:

Small frequent meals, Avoid spicy & fatty foods.
Ginger supplements (Safe & effective).

Oral Antiemetics:

Pyridoxine (Vitamin B6) ± Doxylamine (Antihistamine) (First-line).
Metoclopramide, Ondansetron (If symptoms persist).

B. Severe Cases (Hospital Admission Required)

IV Fluid Therapy:

0.9% Normal Saline + Dextrose (Avoid rapid glucose to prevent Wernicke’s).
Correct Electrolytes (K⁺, Na⁺, Mg²⁺).

IV Antiemetics:

Ondansetron (5-HT3 Antagonist).
Metoclopramide (Prokinetic).

Thiamine Supplementation (100 mg IV Daily) Before Glucose.

Enteral/Parenteral Nutrition (If Persistent).

6. Summary Table: Hyperemesis Gravidarum

Feature	Hyperemesis Gravidarum	Morning Sickness
Onset	4–6 weeks, Peaks at 9–13 weeks	4–6 weeks, Resolves by 12–16 weeks
Vomiting Severity	Severe, Persistent	Mild to Moderate
Weight Loss	>5% of body weight	None or minimal
Ketosis	Present	Absent
Hospitalization Needed?	Often Required	Not needed
Management	IV Fluids, Antiemetics, Thiamine	Dietary changes, Pyridoxine

7. Key Takeaways

Hyperemesis gravidarum is severe, persistent vomiting with dehydration & weight loss.
Risk factors include high hCG (Multiple pregnancy, Molar pregnancy).
Ketosis & Electrolyte imbalances confirm severity.
Management includes IV fluids, Antiemetics, Thiamine, & Nutritional Support.

5 Homeopathic Medicines for Hyperemesis Gravidarum (Severe Pregnancy Vomiting)

Hyperemesis gravidarum is severe, persistent nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte imbalances. It is more intense than regular morning sickness and may require hospitalization if left untreated. Homeopathy can help control nausea, restore appetite, and prevent complications.

Severe cases with dehydration, electrolyte imbalance, or significant weight loss require IV fluids and medical management. Homeopathy can be used as a complementary therapy.

1. Ipecacuanha (For Persistent, Unrelenting Nausea & Vomiting)

Constant nausea, unrelieved by vomiting.
Vomiting of food, bile, or mucus with no relief.
No thirst despite excessive salivation.
Weakness, dizziness, and faintness due to repeated vomiting.
Worse from movement, better when lying still.

2. Nux Vomica (For Nausea Worsened by Eating & Smells)

Nausea in the morning, worse after eating or smelling food.
Vomiting with retching, but feels temporarily better afterward.
Irritable, oversensitive to noise, smells, and light.
Feels bloated, heavy, and unwell after eating.
Worse after coffee, spicy food, and mental stress.

3. Sepia Officinalis (For Nausea with Extreme Weakness & Aversion to Food)

Aversion to food and cooking smells, especially meat.
Feeling of emptiness in the stomach but cannot eat.
Irritability, indifference, and emotional detachment.
Extreme exhaustion and desire to lie down all the time.
Better from vigorous exercise, worse from strong odors.

4. Colchicum Autumnale (For Nausea from the Smell of Food)

Strong aversion to food, especially eggs, fish, and meat.
Even the thought of food causes nausea.
Extreme sensitivity to odors, making nausea worse.
Weakness and excessive salivation.
Worse from motion, better from lying still in a cool room.

5. Kreosotum (For Nausea with Sour, Offensive Vomiting)

Vomiting of undigested food several hours after eating.
Sour, bitter, offensive-smelling vomit.
Burning sensation in the stomach after vomiting.
Excessive thirst but cannot retain fluids.
Worse after eating, better from fresh air.

Key Takeaways

Ipecacuanha: Best for persistent nausea that does not improve after vomiting.
Nux Vomica: Used for nausea worsened by food, smells, and irritability.
Sepia: Helps nausea with extreme fatigue, food aversion, and emotional indifference.
Colchicum: Treats nausea triggered by the smell of food, especially meat and eggs.
Kreosotum: Relieves nausea with sour, offensive-smelling vomit and burning in the stomach.

Important Note:

Severe hyperemesis gravidarum can lead to dehydration and malnutrition—seek medical help if symptoms persist.
Frequent small meals, hydration, and ginger tea can help manage mild nausea.
Electrolyte replacement is essential if vomiting leads to dehydration.
Homeopathy should be used alongside conventional treatment to prevent complications.

Hyperemesis Gravidarum (HG): Causes, Symptoms, and Homeopathic Remedies