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The differences between hyperemesis gravidarum and morning sickness

When morning sickness deserves the royal treatment

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When it was announced that Kate Middleton was pregnant and hospitalized with morning sickness, the media was quick to jump on the story portraying a diva attitude. Many stated that nearly every pregnant woman experiences morning sickness at some point in her pregnancy. Then, it was determined that the Duchess of Cambridge was suffering from hyperemesis gravidarum, a very serious condition that only certain pregnant women experience.

“I almost thought I was dying,” says 34-year-old Manhattan mom, Dana Goldberg, who also suffered from the condition. The mom of 2-year-old Bryson says that merely hearing about Middleton’s story made her feel queasy, because it brought her right back to the days of her pregnancy when she couldn’t keep even a tiny sip of water down. “I threw up 12 to 15 times a day … every day. I felt completely depleted.”

Most pregnant women get nauseous at some point in the first trimester, but hyperemesis gravidarum is an entirely different situation. So how do you know when it’s just normal pregnancy nausea or a serious condition?

Dr. Joanne Stone, professor of Obstetrics, Gynecology, and Reproductive Sciences at Mt. Sinai Medical Center, and director of the Division of Maternal-Fetal Medicine and Perinatal Ultrasound, points out that “with hyperemesis, the degree of nausea and vomiting is severe. Patients feel week, often have significant weight loss, and when seen by their healthcare provider, they are dehydrated. They are often tested for the presence of ketones, which is a sign of severe dehydration and starvation.”

Dr. Stone — who along with Dr. Keith Eddleman, wrote, “My Pregnancy and Baby, The Pregnancy Bible and Your Second Pregnancy” — says it is vital to seek help if you think you might have it.

“If you are constantly vomiting, unable to keep food down, feel dehydrated and are losing weight, see your doctor and go to the emergency room.”

“Next time, I would ask — no, demand — help sooner and not just chalk it up to normal pregnancy symptoms,” says Goldberg. “I think, as women, we are so reluctant to speak up for ourselves. It took me until I was physically unable to leave my bed to convince my doctor that something was very wrong.”

There is no need to suffer silently. Now, there are several treatments available.

“Some treatment options involve non-pharmacologic therapy, such as acupressure or P6 wrist bands. Lifestyle changes, such as trying to eat small, frequent meals, bland foods, and avoiding spicy foods, may be helpful. Ginger supplements of 250 milligram tablets four times a day is worth a try,” says Dr. Stone. “If the nausea and vomiting is persistent, trying various combinations of medications may be successful. Pyridoxine, 25 milligrams every six to eight hours, plus Doxylamine once a day, can do the trick.

If this doesn’t work, stop the Doxylamine and substitute another antihistamine. You can also try other agents, such as Metoclopromide. Many women find Ondansetron (Zofran) a real lifesaver, taking four to eight milligrams every eight hours. Some studies show steroids given by IV may work for some women.”

For Goldberg, a mix of Zofran, ginger supplements, and a lot of rest, eventually helped lessen her symptoms.

Luckily, in most cases, hyperemesis gravidarum improves by the 12-week mark, although rare cases have been reported in second and third trimesters.

Danielle Sullivan, a mom of three, has worked as a writer and editor in the parenting world for more than 10 years. Sullivan also writes about pets and parenting for Disney’s Babble.com. Find her on Facebook and Twitter @DanniSullWriter, or on her blog, Just Write Mom.

Updated 4:32 pm, July 9, 2018
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