Cannabinoid Hyperemesis Syndrome Caused Severe Vomiting Mistaken for Morning Sickness

Two cases of CHS in pregnancy were described. Case 1: a woman with vomiting episodes at weeks 5, 14, and 30 of gestation; the link to hot bathing for relief led to CHS diagnosis. Symptoms resolved with cannabis cessation; healthy baby born at 38+5 weeks. Case 2: vomiting at weeks 16 and 18; 14+ year cannabis use history disclosed after hot bathing pattern identified. Symptoms resolved with cessation; baby born at 37 weeks with low birth weight (2180g) requiring 5 days in NICU. No relapse at 5 months postpartum with sustained cessation.

Case series of two pregnant women diagnosed with cannabinoid hyperemesis syndrome, with clinical workup, treatment course, and outcomes documented through delivery and postpartum follow-up.

CHS in pregnancy is likely underdiagnosed because severe nausea and vomiting are expected symptoms of pregnancy. When anti-emetic treatments fail, the hot bathing clue should prompt inquiry about cannabis use. Misdiagnosis leads to repeated hospitalizations and delays appropriate management.

As cannabis use during pregnancy increases (6-10% by recent estimates), CHS cases in pregnancy will likely rise. The condition is easily missed when clinicians attribute all vomiting to typical pregnancy-related nausea.

Case series of only two patients. Cannot establish prevalence. Case 2 had confounding factors (14+ years of heavy cannabis use, low birth weight may have multiple causes). No standardized CHS diagnostic criteria applied.