By Annette Pinder
Not long ago, the world watched as the Duchess of Cambridge, Kate Middleton, struggled with severe morning sickness that required a hospital stay and intravenous fluids. It turns out that Ms. Middleton wasn’t just suffering from common morning sickness. Instead, she had a condition known as hyperemesis gravidarum (HG), a complication of pregnancy associated with extreme nausea, vomiting, and dehydration. Thomas Guttuso, Jr., M.D., Associate Professor of Neurology, Obstetrics & Gynecology, University at Buffalo says, “HG occurs during the first trimester of pregnancy and usually lasts significantly longer than morning sickness. While most women experience near-complete relief from morning sickness symptoms near the beginning of their second trimester some sufferers of HG experience severe symptoms until they give birth to their baby, and sometimes even after giving birth.”
According to Dr. Guttuso, HG affects up to two percent of pregnant women, and malnutrition and other serious complications, such as fluid electrolyte imbalances, may result. Unlike morning sickness, HG can cause severe weight loss and, although rare, can be life threatening if not treated.
One young woman who suffered from the condition during her entire pregnancy, said, “The comparison of HG to morning sickness is like breaking your arm in several places and then being told you’ve just knocked your funny bone. The condition is truly debilitating.”
Dr. Guttuso says the exact cause of HG is unknown, but experts believe it is due to a combination of factors that may vary between women and include genetics, body chemistry, and overall health. The main problem with HG is that typical anti-nausea medications are ineffective and, as a result, women with HG suffer tremendously for a long period of time. Because there are no effective treatments for HG, studies have shown that about 15% of HG suffers choose to terminate their pregnancies due to the severe disability and potential medical complications caused by the pregnancy. This is a traumatizing decision for most women to be faced with and is a direct result of our lack of effective treatments for HG.
Now, Dr. Guttuso is excited about a clinical research study that he is conducting along with the University of Rochester comparing the effectiveness of two medications in treating HG. Women who participate in the study will receive one of two medications for 1-2 weeks to treat their nausea and vomiting, and then will have the chance to try both medications for as long as needed during their pregnancy. Use of one of these medications was associated with an 80% reduction in nausea, a 94% reduction in vomiting, and almost normal restoration of eating and drinking among 7 women with HG in an earlier study. Best of all, neither of these medications is associated with a risk for birth defects. This study is being funded by the National Institutes of Health.
If you or someone you know is pregnant, experiencing severe nausea and vomiting, and has required intravenous fluids, you can find out more about this study by calling or texting 716-491-8821 or emailing Dr. Guttuso’s assistant, Rachel LaPorta at rlaporta@buffalo.edu. You can also visit clinicaltrials.gov/ct2/show/NCT02163434? for more information.
