The medications found to improve hyperemesis gravidarum symptoms without causing detrimental effects to the fetus are listed in Table 2. Metoclopramide, when compared with promethazine, proved to cause less drowsiness, dizziness, and dystonia. Steroids were found to relieve symptoms better than promethazine, but are only to be used if all other causes of vomiting have been excluded. Ginger was found to significantly improve the nausea and vomiting of hyperemesis. With severe hyperemesis, more invasive measures have been shown to improve symptoms. Nasogastric feedings relieved symptoms and decreased length of hospital stay. TPN shifted the patients from a catabolic state to an anabolic state and improved their nutritional status. This method, however, does have risks