current state of HG treatment and research?
Penny cited the following
8 peer-reviewed research articles
5 professionally-backed sources
1 article from a healthcare institution
The Current State of Hyperemesis Gravidarum (HG) Treatment and Research
Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy that can lead to dehydration, weight loss, and significant impacts on quality of life. While there are established treatments, research continues to seek more effective and better-tolerated options. The understanding of HG’s causes and optimal management is still evolving, and high-quality evidence for many treatments remains limited.
What’s Standard in HG Treatment Today?
Tiered Approach, Focused on Symptom Relief and Safety
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First-line treatments often start with lifestyle and dietary changes, such as eating small, frequent meals and avoiding triggers, though evidence for these is limited.
1ArticleHyperemesis Gravidarum - StatPearls - NCBI BookshelfHyperemesisgravidarum management strategies depend on the severity of symptoms, hydration levels, and the patient's ability to tolerate food or fluids orally. Treatment guided by ACOG nausea and vomiting in pregnancy guidelines is recommended, in which management approaches progress in a tiered ...→
National Center for Biotechnology Information
2ArticleTreatment of Hyperemesis Gravidarum - PMCRecent research now provides additional ... effects. Medicinal methods of prevention and treatment include nutritional supplements and alternative methods, such as hypnosis and acupuncture, as well as pharmacotherapy....→PubMed Central
3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→Wiley Online Library - Obstetrics & Gynecology
- Pharmacologic therapy is the mainstay for moderate to severe cases. Common medications include:
- Antihistamines (e.g., doxylamine, sometimes combined with vitamin B6/pyridoxine)
- Phenothiazines (e.g., promethazine)
- Metoclopramide
- Ondansetron (often used, but with some ongoing debate about safety in early pregnancy)
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Corticosteroids may be considered in severe, refractory cases.
1ArticleHyperemesis Gravidarum - StatPearls - NCBI BookshelfHyperemesisgravidarum management strategies depend on the severity of symptoms, hydration levels, and the patient's ability to tolerate food or fluids orally. Treatment guided by ACOG nausea and vomiting in pregnancy guidelines is recommended, in which management approaches progress in a tiered ...→3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→4Article698 Reprinted from Australian Family Physician Vol. 36, No. 9, September 2007Nausea and vomiting are common symptoms in early pregnancy. In most women the condition is mild and self limiting. A small percentage of women experience severe nausea and vomiting. This is known as hyperemesisgravidarum. Outcomes have improved with intravenous rehydration therapy.→
Royal Australian College of General Practitioners
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IV fluids are used for dehydration and electrolyte imbalances. In severe cases, nutritional support via tube feeding or intravenous nutrition may be needed.
1ArticleHyperemesis Gravidarum - StatPearls - NCBI BookshelfHyperemesisgravidarum management strategies depend on the severity of symptoms, hydration levels, and the patient's ability to tolerate food or fluids orally. Treatment guided by ACOG nausea and vomiting in pregnancy guidelines is recommended, in which management approaches progress in a tiered ...→3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→5ArticleHyperemesis Gravidarum: Causes, Symptoms & TreatmentHyperemesisgravidarum is the medical term for severe nausea and vomiting during pregnancy. The symptoms can be very uncomfortable. You might vomit more than three times a day, become dehydrated, feel constantly dizzy and lightheaded and lose weight. Fortunately there are treatments available, ...→
Cleveland Clinic
6ArticleSevere vomiting in pregnancy - NHSTreatment can include intravenous fluids, which are given directly into a vein through a drip. If you have severe vomiting, the anti-sickness drugs may also need to be given into a vein or a muscle. The charity Pregnancy Sickness Support has information and tips on coping with nausea and vomiting, ...→nhs.uk
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Psychological support is increasingly recognized as important, as HG is associated with higher rates of anxiety, depression, and trauma symptoms.
1ArticleHyperemesis Gravidarum - StatPearls - NCBI BookshelfHyperemesisgravidarum management strategies depend on the severity of symptoms, hydration levels, and the patient's ability to tolerate food or fluids orally. Treatment guided by ACOG nausea and vomiting in pregnancy guidelines is recommended, in which management approaches progress in a tiered ...→3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→
What’s New and Emerging in HG Research?
Ongoing Challenges and Areas of Focus
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Limited high-quality evidence: Despite many available treatments, few have robust, high-quality studies supporting their use specifically for HG. Most evidence is extrapolated from studies on milder nausea and vomiting of pregnancy.
3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→7ArticleDiagnosis and treatment of hyperemesis gravidarum - PMCA 2015 systematic review showed ... in pregnancy.16 · Definitions for hyperemesisgravidarum in clinical and research settings have had a high degree of heterogeneity and historically relied on the presence of ketonuria such as the Fairweather criteria, published in 1968 (Box 2).17,18 However, current evidence does ...→8ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - PubMedCurrent best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support. There is a lack of high-quality evidence on treatment for HG. Future research should focus on understanding the cause, developing effective ...→
PubMed
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Alternative therapies: Some research has explored ginger, acupuncture, and hypnosis. Ginger may help with mild symptoms but is often not effective for HG and can worsen symptoms for some.
Acupressure and hypnosis have mixed evidence and are not widely adopted.7ArticleDiagnosis and treatment of hyperemesis gravidarum - PMCA 2015 systematic review showed ... in pregnancy.16 · Definitions for hyperemesisgravidarum in clinical and research settings have had a high degree of heterogeneity and historically relied on the presence of ketonuria such as the Fairweather criteria, published in 1968 (Box 2).17,18 However, current evidence does ...→9ArticleTreatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment - PMCNausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesisgravidarum (HG) - ...→4Article698 Reprinted from Australian Family Physician Vol. 36, No. 9, September 2007Nausea and vomiting are common symptoms in early pregnancy. In most women the condition is mild and self limiting. A small percentage of women experience severe nausea and vomiting. This is known as hyperemesisgravidarum. Outcomes have improved with intravenous rehydration therapy.→10ArticleHyperemesis Gravidarum Treatment & Management: Approach Considerations, Medical Care, ConsultationsKoren G, Maltepe C. Preemptive Diclectin therapy for the management of nausea and vomiting of pregnancy and hyperemesis gravidarum (abstract). ClinicalTrials.gov. Available athttps://clinicaltrials.gov/show/NCT00293644.→
Medscape
11ArticleHyperemesis Gravidarum: Practice Essentials, Background, PathophysiologyIn some refractory severe cases of hyperemesisgravidarum, if maternal survival is threatened, or if hyperemesisgravidarum is causing severe physical and psychological burden, termination of the pregnancy may be considered. [5] See Treatment and Medication for more detail.→ -
New biological insights: Recent studies are investigating the role of hormones (like human chorionic gonadotropin, hCG) and genetic factors (such as growth differentiation factor 15, GDF15) in HG. These may eventually lead to more targeted therapies, but clinical applications are not yet available.
7ArticleDiagnosis and treatment of hyperemesis gravidarum - PMCA 2015 systematic review showed ... in pregnancy.16 · Definitions for hyperemesisgravidarum in clinical and research settings have had a high degree of heterogeneity and historically relied on the presence of ketonuria such as the Fairweather criteria, published in 1968 (Box 2).17,18 However, current evidence does ...→12ArticleEmerging Progress in Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum: Challenges and Opportunities - PMCPromethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstetr Gynecol. (2010) 115:975–81. 10.1097/AOG.0b013e3181d99290 [DOI] [PubMed] [Google Scholar] 145.Babaei AH, Foghaha MH. A randomized comparison of vitamin B6 and dimenhydrinate in the ...→
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Nutritional management: Research is ongoing into the best ways to prevent and treat malnutrition in HG, including the timing and type of nutritional support.
3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→13ArticleAssessment of management approaches for hyperemesis gravidarum and nausea and vomiting of pregnancy: a retrospective questionnaire analysis | BMC Pregnancy and Childbirth | Full TextIn fact, much of the available research on these medications are based on their use as monotherapies, making treatment with combination therapies based solely on physician experience and preference [15, 18]. Our objective is to identify the subjective efficacy of the various management approaches that are currently in place for nausea and vomiting of pregnancy and hyperemesisgravidarum...→
BioMed Central
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Patient-centered outcomes: There is growing recognition of the need for research that focuses on quality of life, mental health, and patient-reported outcomes, not just physical symptoms.
8ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - PubMedCurrent best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support. There is a lack of high-quality evidence on treatment for HG. Future research should focus on understanding the cause, developing effective ...→ArticleThe far-reaching burden of Hyperemesis Gravidarum - an exploration of women's experiences and perceptions of healthcare support - PubMedFurther research is warranted to determine whether these recommendations would result in improved pregnancy outcomes. Keywords: HyperemesisGravidarum; patient reported outcome; pregnancy; women’s health. ... Women's perspectives on the management and consequences of hyperemesisgravidarum ...→
Gaps and Limitations in Current Knowledge
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No cure: There is currently no cure for HG, and treatments are aimed at reducing symptoms and preventing complications rather than addressing the underlying cause.
3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→7ArticleDiagnosis and treatment of hyperemesis gravidarum - PMCA 2015 systematic review showed ... in pregnancy.16 · Definitions for hyperemesisgravidarum in clinical and research settings have had a high degree of heterogeneity and historically relied on the presence of ketonuria such as the Fairweather criteria, published in 1968 (Box 2).17,18 However, current evidence does ...→
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Variable effectiveness: Many people with HG try multiple medications and therapies, often with limited relief and significant side effects.
13ArticleAssessment of management approaches for hyperemesis gravidarum and nausea and vomiting of pregnancy: a retrospective questionnaire analysis | BMC Pregnancy and Childbirth | Full TextIn fact, much of the available research on these medications are based on their use as monotherapies, making treatment with combination therapies based solely on physician experience and preference [15, 18]. Our objective is to identify the subjective efficacy of the various management approaches that are currently in place for nausea and vomiting of pregnancy and hyperemesisgravidarum...→
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Long-term effects: Some evidence suggests HG may have modest long-term effects on offspring, but more research is needed to clarify these risks.
1ArticleHyperemesis Gravidarum - StatPearls - NCBI BookshelfHyperemesisgravidarum management strategies depend on the severity of symptoms, hydration levels, and the patient's ability to tolerate food or fluids orally. Treatment guided by ACOG nausea and vomiting in pregnancy guidelines is recommended, in which management approaches progress in a tiered ...→7ArticleDiagnosis and treatment of hyperemesis gravidarum - PMCA 2015 systematic review showed ... in pregnancy.16 · Definitions for hyperemesisgravidarum in clinical and research settings have had a high degree of heterogeneity and historically relied on the presence of ketonuria such as the Fairweather criteria, published in 1968 (Box 2).17,18 However, current evidence does ...→
What’s on the Horizon?
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Better understanding of causes: Ongoing research into genetic, hormonal, and environmental factors may lead to more effective and individualized treatments.
12ArticleEmerging Progress in Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum: Challenges and Opportunities - PMCPromethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstetr Gynecol. (2010) 115:975–81. 10.1097/AOG.0b013e3181d99290 [DOI] [PubMed] [Google Scholar] 145.Babaei AH, Foghaha MH. A randomized comparison of vitamin B6 and dimenhydrinate in the ...→
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Improved therapies: There is a strong need for new medications and supportive therapies that are both effective and well-tolerated, as well as for better integration of psychological care.
3ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - Minnen - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online LibraryHyperemesis gravidarum (HG) is ... their offspring. Current best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support....→8ArticleThe impact and management of hyperemesis gravidarum: Current and future perspectives - PubMedCurrent best-practice management includes symptomatic treatment with anti-emetic pharmacological treatment, rehydration if needed, and psychological support. There is a lack of high-quality evidence on treatment for HG. Future research should focus on understanding the cause, developing effective ...→
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Guideline development: Professional organizations are updating guidelines as new evidence emerges, but recommendations may still vary by region and provider.
14ArticleThe Management of Nausea and Vomiting of Pregnancy and Hyperemesis GravidarumAm J Obstet Gynecol 1998; ... Leveno KJ. A randomized, placebo-controlled trial of · corticosteroids for hyperemesis due to pregnancy. Obstet · Gynecol 2003;102:1250–4. ... Bondok RS, El Sharnouby NM, Eid HE, Abd Elmaksoud AM. Pulsed steroid therapy is an effective treatment for→
Royal College of Obstetricians & Gynaecologists
ArticleThe Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (Green‐top Guideline No. 69) - Nelson‐Piercy - 2024 - BJOG: An International Journal of Obstetrics & Gynaecology - Wiley Online LibraryThere is variation in the care ... (NVP) or hyperemesisgravidarum (HG) with the potential for lack of understanding of its severity and options for treatment and support. The aim of this guideline is to provide updated evidence-based or best clinical practice information regarding the diagnosis and subsequent management of NVP and ...→
Taking Action: What This Means for You
If you are experiencing HG, current best practice is a stepwise approach that may include medications, IV fluids, nutritional support, and mental health care. Because HG can be complex and severe, working closely with your OB/GYN or maternal-fetal medicine specialist is important for personalized management. Research is ongoing, and new options may become available in the future.
Moving Forward: The Importance of Advocacy and Research
HG is increasingly recognized as a serious condition deserving of more research, better treatments, and greater support for those affected. Advocacy groups and patient-centered research are helping to drive progress in this area.