Hyperemesis gravidarum (synonyms: extreme morning sickness, ICD-10-GM O21: excessive vomiting during pregnancy) is extreme vomiting during gravidity (pregnancy).
The following forms of hyperemesis gravidarum are distinguished according to ICD-10-GM:
- ICD-10-GM O21.0 Mild hyperemesis gravidarum Includes: Hyperemesis gravidarum, mild or unspecified, onset before completion of 20th week of gestation.
- ICD-10-GM O21.1 Hyperemesis gravidarum with metabolic disorder Incl.: Hyperemesis gravidarum, onset before the end of the 20th week of gestation, with metabolic disorder, such as:
- Dehydration (lack of fluids).
- Hypoglycemia (low blood sugar)
- Disturbance of the electrolyte balance (salt balance)
- ICD-10-GM O21.2 Late vomiting during pregnancy Incl: Excessive vomiting, onset after 20 completed weeks of gestation.
Clinically, two degrees of severity can be distinguished:
- Grade 1: Hyperemesis with feeling of illness without metabolic derailment.
- Grade 2: Hyperemesis with pronounced feeling of illness and metabolic derailment.
Prevalence (frequency of illness): emesis gravidarum (morning sickness) occurs in up to 50% of women at the beginning of gravidity (pregnancy). It usually resolves by the 16th (-20th) week of gestation at the latest, although in up to 20% of cases symptoms may persist throughout the entire gravidity. First-time mothers and pregnant women with multiple pregnancies are particularly commonly affected. Hyperemesis gravidarum refers to the exaggerated form of morning sickness, i.e., persistent vomiting with a frequency of more than five times per day, weight loss of more than 5% of body weight or > 3 kg, a pronounced feeling of illness, and impaired food and fluid intake. This occurs in up to 2% of pregnant women. In approximately 0.5-1% of pregnant women, the condition takes threatening forms for both mother and unborn child.
Course and prognosis: Emesis gravidarum does not usually require special therapy. Dietary measures are sufficient. Hyperemesis gravidarum requires inpatient treatment, as there may be considerable fluid and electrolyte losses. Parenteral nutrition (form of artificial nutrition that bypasses the gastrointestinal tract) may be required.
