Background: Hyperemesis gravidarum (HG) is a disease that occurs during
pregnancy. It is relatively rare (0.3–3.6%), but with great potential for
complications. Its diagnostic criteria still lack consensus, and most studies
only establish the presence of uncontrollable vomiting, requiring
hospitalization. The present study aimed to investigate its epidemiological
profile and maternal and neonatal outcomes in a series of cases with more
restrictive diagnostic criteria. Methods: A retrospective analysis of
all cases admitted with a diagnosis of HG, according to more restrictive service
criteria, was performed with a review of medical records and laboratory tests in
a Brazilian university hospital. Results: HG was confirmed in 85 cases
(0.39% incidence). The most frequent early symptoms included a weight loss
5% (94.4%) or 10% (63.9%), dehydration (76.5%), hyponatremia
(49.4%), hypokalemia (40.5%), increased liver enzymes (46.4%), and transient
hyperthyroidism (38.6%). Enteral nutrition was used in 7.1% of the patients,
and parenteral nutrition in 1.2%. A large majority of patients was provided with
a prescription of more than one drug, and the most used drugs were dimenhydrinate
(87.1%), metoclopramide (85.9%), and ondansetron (38.8%). The average length
of hospital stay was 15 days (1–145 days). Childbirth data were obtained from 40
patients, with 60% of births being cesarean deliveries, 35.3% premature births,
32% with low birth weight, and 7.5% stillbirths, with 12.5% of cases having
postpartum complications. The overall rate for clinical complications was 30.5%.
Conclusions: With well-defined and more restrictive criteria, we
observed a high rate of obstetric and neonatal complications compared to
international data. Thus, a correct diagnosis is essential for identifying this
serious condition and to allow earlier treatment, reducing clinical, obstetric,
and neonatal complications.