Hyperemesis Gravidarum

Hyperemesis gravidarum (HG) is severe, persistent nausea and vomiting of pregnancy that goes far beyond ordinary morning sickness. It causes dehydration, electrolyte imbalance, ketosis, and weight loss greater than 5% of the pregnant person's pre-pregnancy body weight, and it frequently requires medical intervention and hospitalization. HG affects roughly 0.5 to 2 percent of pregnancies and is the leading cause of hospitalization during the first trimester. Symptoms typically begin between 4 and 6 weeks of gestation, peak around 8 to 12 weeks (mirroring the peak in human chorionic gonadotropin, or hCG), and usually improve by 16 to 20 weeks, although a minority of people remain symptomatic throughout pregnancy. The distinction between HG and normal nausea and vomiting of pregnancy (NVP) is clinically important. NVP is uncomfortable but self-limiting and does not threaten hydration or nutrition. HG, by contrast, prevents adequate oral intake, produces measurable physiologic harm, and demands a structured nursing and medical response. Diagnostic hallmarks include persistent vomiting with the inability to maintain oral hydration, weight loss exceeding 5% of baseline weight, dehydration with ketonuria, and electrolyte abnormalities such as...