■ 1st trimester

Nausea and vomiting are common during early pregnancy and can occur at any time of day (see also Morning sickness; Nausea throughout the day). But sometimes vomiting is so severe that a pregnant woman can't eat or drink enough to maintain proper nutrition and stay hydrated. This condition is called hyperemesis gravidarum, the medical term for excessive vomiting in pregnancy.

Hyperemesis gravidarum affects about one in every 300 pregnant women. It's characterized by vomiting that's frequent, persistent and severe. You may also feel faint, dizzy or lightheaded. If not treated, hyper-emesis can keep you from getting the nutrition and fluids you need. You may become dehydrated, which is the most serious complication of this condition. Rarely, the loss of fluids and salts from vomiting can be severe enough to threaten the fetus.

The exact causes of hyperemesis aren't known, but it seems to occur more frequently when the pregnancy hormone human chorionic gonadotropin (HCG) is very high, as in multiple pregnancy and molar pregnancy (a rare condition in which an abnormal mass — instead of a baby — forms inside the uterus after fertilization). It's more common in first pregnancies, young women and women carrying multiple fetuses.

■ Prevention and self-care for vomiting

If you're vomiting only occasionally or about once a day, follow the self-care measures listed under Morning sickness.

■ When to seek medical help for vomiting Contact your health care provider if:

• You have nausea and vomiting so severe that you can't keep any food down

• You're vomiting more than two or three times a day

• Vomiting persists well into the second trimester

• You have some of the signs and symptoms of early or mild dehydration, which include:

• Extreme thirst

• Small amounts of dark yellow urine

• Dizziness that's worse when you stand

• Cramps in your arms or legs

• Dry mouth with thick saliva

Before treating you for hyperemesis, your health care provider will rule out other possible causes of vomiting, such as molar pregnancy, gastrointestinal disorders and thyroid problems.

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