What is Hyperemesis Gravidarum
Hyperemesis Gravidarum (HG) is a severe form of Nausea and Vomiting of Pregnancy (NVP), affecting around 1% of all pregnant women. The cause (or causes) of HG remain unknown and there is no standard definition for when NVP becomes HG, however the most commonly quoted criteria includes: admittance to hospital; weight loss of more than 5% of the pre-pregnancy weight; dehydration; the presence of ketones in the urine; and electrolyte imbalances.
For women with HG the symptoms can be so severe that it is impossible for them to function as normal. Many are bed- or house-bound and the guilt and fear that accompanies the condition can be immense. Huge amounts of stress and pressure is placed upon the entire family when facing HG, and antenatal depression (AND), postnatal depression (PND) and post-traumatic stress disorder (PTSD) are common among families that have experienced a pregnancy complicated by HG.
Since the introduction of IV hydration, HG is no longer the life threatening illness that it once was. However gaining adequate support and treatment is still crucial in surviving a HG pregnancy. This includes the use of antiemetic medication and mental health support. Unfortunately, due to the fact that no antiemetic medications are currently licensed for use during pregnancy combined with fears following the use of Thalidomide in the 50s and 60s, both pregnant mothers and their healthcare practitioners remain reluctant to use antiemetics until symptoms become so severe admittance to hospital is required.
However, there are several antiemetics that are considered safe for use during pregnancy and reluctance to prescribe or take these can unnecessarily prolong the severity of symptoms experienced by a woman with HG.
If you are, or know someone else who is suffering from HG, please do contact your GP to discuss treatment options. It is the unfortunate experience of many women that they have to fight for the treatment they need, just when they have no strength available to fight for it. Therefore, it is always helpful to be as well-informed and supported as possible. This is why I have created this page on my website, to highlight the various resources and support available.
I have come across all of the following since my own HG pregnancy, particularly whilst working on a book about the condition. Due to having a young child, progress on the book is slow. However I have created a few PDF downloads with useful information and included links to charities and support groups that may be able to help.
A Final Note
Though HG is an extreme form of NVP, support should also be available for the many women who experience moderate-severe symptoms. It has been noted that 30% of pregnant women require time off from work to cope with their symptoms and 35% have symptoms of clinical significance. The use of the term "morning sickness" and the fact that NVP is so common (affecting around 80% of all pregnant women to some degree) has led to a belief that NVP is just a "normal" part of pregnancy and something to be tolerated without complaint. It is the hope of many that the term "morning sickness" will eventually cease to be used as it trivialises the condition and makes it harder for an accurate assessment to be made of the severity of symptoms.
This is why, although this page is dedicated specifically to HG, I hope that women who are suffering from moderate-severe NVP will also find useful information here and realise that it is advisable and okay to ask for help. The fact that my experience was not as severe as some of the other ladies' who had HG was a key factor in my reluctance to push for the treatment I needed early on. If NVP symptoms are affecting your ability to function normally, it is always worth contacting your GP or midwife.
Resources
Charities and Support Groups
Pregnancy Sickness Support is a national charity here in the UK that aims to inform and support women, their families, and those involved in their care. They have a wealth of information on their website and run a volunteer support network and a telephone helpline.
Pregnancy Sickness SOS is another UK based site providing information on HG.
The Hyperemesis Education and Research Foundation (Her) is a US based site which also has a huge range of information, research and support available for sufferers, their families and healthcare providers.
The Motherisk Program in Canada carries out lots of research into pregnancy complications and possible treatment options for them, including HG. Some of their research is included below.
The Ayden Rae Foundation is an organisation that is fighting hard to aid the discovery of a cause and cure for HG.
Steunpunt HG is a Dutch website offering support and information to HG sufferers.
If you are aware of any other sites, particularly other charities or support groups in countries not covered above, then please do contact me with details.
PDF Downloads
The following downloads are all created from the work I am doing on the HG book. I hope you will find them helpful.
This "Cheat Sheet" includes facts and information on NVP and HG that may be useful to print off and take with you to GP appointments, meetings at work or simply to inform any "doubting" family or friends.
Research
The following research papers are all free to access. Please note, however, that many of these are not UK based and so treatment protocols that are common in Canada or the US may not be accepted by healthcare practitioners here in the UK.
Nausea and Vomiting of Pregnancy: A Literature Review
Motherisk Update: Treatment of nausea and vomiting in pregnancy
Optimal management of nausea and vomiting of pregnancy
