Signs and Symptoms of Hyperemesis Gravidarum:

Severe nausea and vomiting Food aversions Weight loss of 5% or more of pre-pregnancy weight Decrease in urination Dehydration Headaches Confusion Fainting Jaundice

Difference between: Morning Sickness: Hyperemesis Gravidarum: Nausea sometimes accompanied by vomiting Nausea accompanied by severe vomiting Nausea that subsides at 12 weeks or soon after Nausea that does not subside Vomiting that does not cause severe dehydration Vomiting that causes severe dehydration Vomiting that allows you to keep some food Vomiting that does not allow you to keep any food down down

Hyperemesis Gravidarum

Hyperemesis gravidarum is uncontrollable vomiting during pregnancy that results in dehydration, weight loss, and ketosis. Diagnosis is clinical and by measurement of urine ketones and renal function. Treatment is with temporary suspension of oral intake and with IV fluids, antiemetics if needed, and vitamin and electrolyte repletion.

Key things to remember about hCG levels:

In a bout 85% of normal pregnancies, the hCG level will double every 48 - 72 hours. As you get further along in pregnancy and the hCG level gets higher, the time it takes to double can increase to about every 96 hours. Caution must be used in making too much of hCG numbers. A normal pregnancy may have low hCG levels and result in a perfectly healthy baby. The results from an ultrasound after 5 - 6 weeks gestation are much more accurate than using hCG numbers. An hCG level of less than 5mIU/ml is considered negative for pregnancy, and anything above 25mIU/ml is considered positive for pregnancy. The hCG hormone is measured in milli-international units per milliliter (mIU/ml). A transvaginal ultrasound should be able to show at least a gestational sac once the hCG levels have reached between 1,000 - 2,000mIU/ml. Because levels can differentiate so much and conception dating can be wrong, a diagnosis should not be made by ultrasound findings until the hCG level has reached at least 2,000. A single hCG reading is not enough information for most diagnoses. When there is a question regarding the health of the pregnancy, multiple testings of hCG done a couple of days apart give a more accurate assessment of the situation. The hCG levels should not be used to date a pregnancy since these numbers can vary so widely. There are two common types of hCG tests. A qualitative hCG test detects if hCG is present in the blood. A quantitative hCG test (or beta hCG) measures the amount of hCG actually present in the blood.

Guideline to hCG levels during pregnancy: hCG levels in weeks from LMP (gestational age)* :

3 weeks LMP: 5 - 50 mIU/ml 4 weeks LMP: 5 - 426 mIU/ml 5 weeks LMP: 18 - 7,340 mIU/ml 6 weeks LMP: 1,080 - 56,500 mIU/ml 7 - 8 weeks LMP: 7, 650 - 229,000 mIU/ml 9 - 12 weeks LMP: 25,700 - 288,000 mIU/ml 13 - 16 weeks LMP: 13,300 - 254,000 mIU/ml 17 - 24 weeks LMP: 4,060 - 165,400 mIU/ml

25 - 40 weeks LMP: 3,640 - 117,000 mIU/ml Non-pregnant females: <5.0 mIU/ml Postmenopausal females: <9.5 mIU/ml