Hyperemesis Gravidarum: When to Go to Hospital

If you have hyperemesis gravidarum (HG), knowing when to go to hospital can be confusing. You don't want to waste NHS resources, but you also don't want to ignore dangerous dehydration. This guide will help you recognise when home treatment isn't enough and when you need urgent medical care.

Table of Contents

1. When to Go to Hospital
2. Red Flag Symptoms
3. What Happens at Hospital
4. How to Prepare for a Hospital Visit
5. After Hospital: What Next?
6. When to Call 111 vs 999
7. FAQ

When to Go to Hospital

Dehydration Signs

• Can't keep any fluid down for 12-24 hours
• Very dark urine or no urine for 8+ hours
• Dry mouth, lips, and tongue
• Dizziness when standing up
• Feeling faint or actually fainting
• Sunken eyes
• Skin that doesn't bounce back when pinched

Severe Vomiting

• Vomiting 5+ times per day despite medication
• Vomiting blood (red, brown, or coffee-ground appearance)
• Unable to keep anti-sickness medication down
• Vomiting that's getting worse rather than improving

Weight Loss

• Lost 5% or more of your pre-pregnancy weight
• Can't eat anything for 24+ hours

Other Concerning Symptoms

• Severe abdominal pain
• Confusion or extreme drowsiness
• Rapid or irregular heartbeat
• Fever (38°C or above)
• Chest pain

Red Flag Symptoms

• Vomiting blood - could indicate serious bleeding
• Severe abdominal pain - could indicate other complications
• Confusion or can't stay awake - severe dehydration
• Fainting - dangerously low blood pressure
• Chest pain - needs urgent assessment
• Very rapid heartbeat at rest - could indicate electrolyte imbalance
• No urine for 12+ hours - severe dehydration

These are emergencies. Don't wait - seek help immediately.

What Happens at Hospital

Assessment

When you arrive:

1. Triage nurse will assess your symptoms and vital signs
2. Blood tests to check electrolytes, kidney function, and blood count
3. Urine test to check for ketones (signs of starvation)
4. Blood pressure and heart rate monitoring
5. Possibly an ultrasound to check the pregnancy (especially if it's your first presentation)

Treatment

Treatment typically includes:

1. IV fluids - to rehydrate you (this is the most important treatment)
2. IV anti-sickness medication - given directly into your bloodstream for maximum effect
3. IV vitamins - especially thiamine (vitamin B1), which is essential if you've been vomiting a lot
4. Monitoring - of your urine output, vital signs, and ketone levels

Duration of Stay

Most HG admissions are 1-3 days. You'll usually be discharged when:

• You can keep oral fluids down
• Your ketones have cleared
• Your electrolytes are normal
• You can keep oral anti-sickness medication down

Some women need longer stays or multiple admissions during their pregnancy.

Which Ward?

You may be admitted to:

• Gynaecology ward
• Early pregnancy unit
• Maternity assessment unit
• A&E observation unit (for very short stays)

How to Prepare for a Hospital Visit

Pack a Bag

• Your maternity notes (if you have them)
• Medication list - what you're taking and when
• Phone charger
• Comfortable clothes - loose, easy to remove
• Sick bowls for the journey
• Tissues and lip balm (lips get dry)
• Water bottle (you'll be allowed sips)
• Snacks for when you can eat (plain biscuits, crackers)
• Headphones for listening to music or podcasts
• Book or tablet - you may be bored between treatments

Before You Go

• Call your GP or midwife if it's during the day - they may be able to help without hospital
• Call 111 if you're not sure if you need to go to hospital - they can advise
• Have someone drive you - don't drive yourself if you're vomiting or dizzy
• Tell the hospital you're pregnant when you arrive

After Hospital: What Next?

Follow-Up

• See your GP within a few days of discharge
• Tell your midwife about your admission
• Ask about ongoing treatment - you may need regular check-ins
• Monitor for ketones at home with testing strips (ask your midwife)

Preventing Readmission

• Sip fluids constantly - aim for 2 litres per day
• Take medication on time - set alarms
• Eat small amounts of whatever you can tolerate
• Rest - exhaustion makes HG worse
• Ask for help - don't try to manage alone

If You Need to Go Back

It's not uncommon to need multiple hospital admissions with HG. Don't feel like a failure if you need to go back. HG is unpredictable, and sometimes home treatment simply isn't enough.

When to Call 111 vs 999

111 can arrange an urgent GP appointment or direct you to the right service.

Call 999 or Go to A&E If:

• You're vomiting blood
• You have severe abdominal pain
• You're confused or can't stay awake
• You've fainted
• You have chest pain
• You have no urine for 12+ hours
• You feel critically unwell

Don't hesitate to call 999 if you're seriously unwell. HG can be dangerous if untreated.

Frequently Asked Questions

Go to hospital if you can't keep any fluids down for 12-24 hours, have dark or no urine, feel dizzy or faint, are losing weight, or are vomiting blood. When in doubt, call 111 for advice.

What will they do for me in hospital?

You'll receive IV fluids to rehydrate, IV anti-sickness medication, and monitoring of your electrolytes and urine output. Most women stay 1-3 days until they can keep oral fluids down.

Will going to hospital harm my baby?

No. Hospital treatment for HG is safe and protects your baby by treating dehydration and malnutrition. Untreated HG is far more dangerous than hospital treatment.

Can I refuse to go to hospital?

You can refuse treatment, but HG can become dangerous if untreated. Severe dehydration and electrolyte imbalance can harm both you and your baby. If you're advised to go to hospital, it's because you need treatment.

How many times might I need to be admitted?

Some women need one admission and are then stable. Others need multiple admissions during their pregnancy, especially before week 14. This is normal and not a sign of failure - HG is unpredictable.

Further reading:

• NHS — Vomiting and morning sickness in pregnancy

This article is for informational purposes only and does not constitute medical advice. Always consult your GP or midwife with any concerns about your pregnancy.

Last reviewed: June 2026

Related articles:

• Hyperemesis Gravidarum Guide
• HG Treatment Options in UK
• Dehydration in Early Pregnancy
• Can't Keep Water Down in Pregnancy