Table 1:

The risks of hyperemesis gravidarum for pregnant people and their offspring

Risk	Management
Short-term maternal outcomes
Weight loss21	Refer to a dietitian (preferably with experience in treating hyperemesis gravidarum)21
Dehydration21	Administer IV fluids in either an outpatient clinic or inpatient setting22
Electrolyte imbalances21	Hospital admission to correct electrolyte imbalances21
Wernicke encephalopathy23	Offer thiamine supplementation to patients admitted with prolonged lack of nutrient intake, especially before administration of dextrose or enteral or parenteral nutrition22
Vitamin K deficiency24	Consider vitamin K supplementation (150 μg IV)
Thromboembolism25	Consider thrombosis prophylaxis in patients admitted to hospital or in patients with other risk factors for thromboembolism21
Depression, anxiety, or PTSD2,26,27	Ask about depressive symptoms and offer psychosocial help21
Suicidal ideation28	Ask about suicidal ideation and refer if necessary
Consideration of pregnancy termination28	Ask if patient is considering pregnancy termination, talk about recurrence risks, expand antiemetic treatment, and refer if necessary
Long-term maternal outcomes
Changes to family planning7	After a pregnancy affected by hyperemesis gravidarum, suggest follow-up to discuss future pregnancy and, if desired, make a plan for treatment of hyperemesis gravidarum in a next pregnancy7
Depression, anxiety, or PTSD2,29	Offer psychosocial help21
Perinatal outcomes
Placental abruption30
Birth weight < 1500 g30	Offer ultrasonography to measure fetal growth in pregnancy if symptoms persist beyond second trimester
Preterm delivery30
Resuscitation or admission to NICU30
Long-term outcomes to offspring
Reduced insulin sensitivity30
Anxiety disorders31
Sleep problems31
Attention-deficit/hyperactivity disorder31
Autism spectrum disorder31
Testicular cancer31

Note: IV = intravenous, NICU = neonatal intensive care unit, PTSD = posttraumatic stress disorder.