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HSE National Clinical Guideline

Hyperemesis Gravidarum and Nausea/Vomiting in Pregnancy


Topic: Hyperemesis gravidarum and nausea/vomiting in pregnancy
Document Owner: National Clinical Lead for Guideline Development in Maternity and Gynaecology Services, National Women and Infants Health Programme (NWIHP)
National Group: Guideline Development Programme, National Women and Infants Health Programme
Effective From: 23/10/2026
This Guideline aims to provide evidence-based recommendations for the care of women with NVP and HG as well as promoting a standardised approach nationally across all maternity units for the care of women with NVP and HG.

This national clinical practice guideline presents evidence-based recommendations for the systematic assessment and multidisciplinary management of nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG). It advocates standardised severity evaluation using the PUQE instrument, stratified ambulatory or inpatient care, correction of fluid and electrolyte disturbances, stepwise pharmacological antiemetic therapy, prophylactic thiamine administration, and nutritional intervention where clinically indicated. The guideline further emphasises fetal growth surveillance, venous thromboembolism risk assessment, and trauma-informed psychological support within a coordinated model of maternity care.