Shaping better health
REMEDY : BNSSG referral pathways

Hyperemesis Gravidarum

Checked: 27-11-2017 by Rob.Adams Next Review: 27-11-2018


There are guidelines on management of Hyperemesis Gravidarum in Clinical Knowledge Summaries.

Referral Guidance

There is a one stop hyperemesis clinic on Ward 78 at St Michaels for patients in UBHT catchment and referrals can be made via ICE or the via the on call team. Patients will be given fluids and anti-emetics and sent home the same day if possible.

For other hospitals please contact the appropriate on call team.

Red Flags

CKS list the following red flags:

Consider admitting to hospital if the woman has one of:

  • Continued nausea and vomiting and is unable to keep down liquids or oral antiemetics.

  • Continued nausea and vomiting with ketonuria and/or weight loss (greater than 5% of body weight), despite treatment with oral antiemetics.

  • A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection).

Have a lower threshold for admitting to hospital or seeking specialist advice if the woman has a co-existing condition (for example diabetes) which may be adversely affected by nausea and vomiting. 

Admission or specialist advice may also be required if there is suspicion of an alternative diagnosis or complication requiring specialist management.