Clinical characteristics, management and outcomes of hyperemesis gravidarum: a retrospective study in an Irish maternity hospital

Background: Hyperemesis Gravidarum (HG) in pregnancy is a severe form of nausea and vomiting resulting in dehydration, weight loss and declining mental health. Research on the clinical characteristics and management of HG in Ireland is limited. Aim: To describe a cohort of women with HG attending an Irish Maternity Hospital. Methods: A retrospective chart review of 198 women referred for HG management in an urban stand-alone maternity hospital in Dublin between 2020-2023. Data included medical and obstetric history, management, symptoms and birth outcomes. Results: Most (64.8%) were multiparous, with 77% reporting previous HG. The majority (76.3%) presented in the first trimester. PUQE scores indicated mild (3.4%), moderate (48.3%), or severe (48.3%) nausea and vomiting, and 72.1% rated their wellbeing 5 or lower (on a scale of 0-10). Mean weight loss from pre-pregnancy to first presentation was-2.64kg (SD 3.9), with 39% losing >5%. Dehydration (61.3%) and ketonuria (42.8%) were common. Mean duration of HG care was 11.04 (SD 8.4) weeks. Nearly half (49.5%) trialled 3–4 medications, with 87.9% prescribed Doxylamine/Pyridoxine and/or Prochlorperazine. Hospital resource use was high; 76% required day ward management, 78% attended A&E, and 36.9% needed overnight admission, at least once. Among 187 live births, 55.2% were male, 70% were vaginal deliveries, 9.1% were small for gestational age (<10^thcentile) and 13.4% were large for gestational age (>90^thcentile). Conclusion: HG significantly impacts maternal health and places demands on hospital resources. While birthweight centiles were generally normal, HG’s potential long-term effects on child health warrant further investigation.