Hyperemesis gravidarum, starting before the end of the 20th week of gestation, with metabolic disturbance such as carbohydrate depletionHyperemesis gravidarum, starting before the end of the 20th week of gestation, with metabolic disturbance such as dehydrationHyperemesis gravidarum, starting before the end of the 20th week of gestation, with metabolic disturbance such as electrolyte imbalance