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Clinical features and evaluation of nausea and vomiting of pregnancy

Jerrie S Refuerzo, MD
Judith A Smith, PharmD, BCOP, CPHQ, FCCP, FISOPP
Susan M Ramin, MD
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG


Nausea with or without vomiting is so common in early pregnancy that mild symptoms may be considered part of the normal physiology of the first trimester. However, these symptoms can significantly impact the pregnant woman’s quality of life, especially when persistent and/or severe [1]. Hyperemesis gravidarum is the term used to describe the severe end of the symptom spectrum (weight loss exceeding 5 percent of prepregnancy body weight), but no universally accepted criteria distinguish between mild and severe disease.

The clinical manifestations and diagnostic evaluation of women with nausea and vomiting of pregnancy will be reviewed here. Treatment and outcome of this disorder are discussed separately. (See "Treatment and outcome of nausea and vomiting of pregnancy".)


Some degree of nausea with or without vomiting occurs in up to 90 percent of pregnancies [2]. In a prospective study including almost 800 women followed from conception, 57 percent reported nausea and 27 percent reported both nausea and vomiting by 8 weeks of gestation [3].

The incidence of women with severe symptoms is not well-documented; reports vary from 0.3 to 3 percent of pregnancies [2]. Ethnic differences and differences in the definition of the disease may account, in part, for the variability.


Epidemiology — The epidemiology of pregnancy-related nausea and vomiting remains unclear, but the disorder appears to be more common in Western countries and urban areas than in Africa and Asia [4,5]. Younger primigravid women are more likely to be affected than older multiparous women [6], but data are not consistent.

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Literature review current through: Nov 2017. | This topic last updated: Jan 03, 2017.
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