A pregnant woman with chronic marijuana use had severe nausea and vomiting diagnosed as CHS after initial evaluation for hyperemesis gravidarum, reinforcing the importance of marijuana history in pregnancy nausea.
Read this if you are a healthcare provider or pregnant person wanting to understand CHS in pregnancy.
CHS and hyperemesis gravidarum share nearly identical presentations in pregnancy
What the researchers found
This case report documents a pregnant woman with chronic marijuana use who presented with severe nausea, vomiting, and compulsive bathing, meeting criteria for cannabinoid hyperemesis syndrome. The presentation was initially evaluated as hyperemesis gravidarum due to the shared symptoms.
The authors emphasize that with marijuana legalization increasing, CHS incidence among pregnant women may rise. Recognition of CHS in this population is important because it avoids extensive unnecessary workups, reduces healthcare costs, and directs treatment toward the effective intervention: marijuana cessation.
The case illustrates the value of obtaining a complete substance use history, including marijuana, in all pregnant patients presenting with severe nausea and vomiting.
Why it matters
This is another case demonstrating the diagnostic overlap between CHS and hyperemesis gravidarum. As marijuana becomes more socially acceptable, healthcare providers need to routinely screen for cannabis use in pregnant patients with severe nausea.
The numbers in context
Single case report. Chronic marijuana use history. Nausea, vomiting, compulsive bathing during pregnancy. Diagnosis: CHS.
How the study worked
Single case report with clinical description and literature review of CHS in pregnancy.
What this study cannot tell us
Single case report. Limited clinical detail in the abstract. Cannot establish how common CHS misdiagnosis is in pregnancy.
How to read the evidence
Single case report reinforcing a known diagnostic pitfall.
When this study was published
Published in 2015. Multiple similar case reports have since further established CHS as a differential for pregnancy vomiting.
The bigger picture
The accumulation of CHS case reports in pregnant women is building the case for routine cannabis screening as part of the hyperemesis gravidarum workup. This relatively simple addition to clinical practice could prevent unnecessary invasive testing and hospitalizations.
Questions still open
- Should cannabis screening be standard in the hyperemesis gravidarum workup? Does CHS during pregnancy carry additional risks compared to non-pregnant CHS? How quickly do CHS symptoms resolve with cannabis cessation during pregnancy?
Common questions
How common is CHS in pregnant women?
Does stopping marijuana immediately resolve CHS in pregnancy?
Read the original research
Cannabinoid Hyperemesis Syndrome During Pregnancy: A Case Report.
The Journal of reproductive medicine, 60(9-10), 430-2
Citation
Andrews, Karinna H; Bracero, Luis A. (2015). Cannabinoid Hyperemesis Syndrome During Pregnancy: A Case Report.. The Journal of reproductive medicine, 60(9-10), 430-2.
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