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| HG is no picnic (picture: i-am-pregnant.com ) |
Thrust into the news once again, is the medical issue Hyperemesis Gravidarum. Newspapers and the internet have announced that the Duchess of Cambridge, the former Kate Middleton has been hospitalized with this ailment in England.
Hyperemesis Gravidarum is not the "normal" morning sickness that most women experience in early pregnancy. It is felt to be a response to newly circulating and unfamiliar hormones in response to a developing placenta. Women who experience this may not simply have "morning sickness" but the severe nausea may afflict them throughout the day, and the vomiting may persist following all meals or snacks. It may be so severe that the woman may develop dehydration and fluid and electrolyte imbalance. The wretching can be so significant that it may cause her to rupture blood vessels in her eyes or have pinpoint vessel ruptures in and around her face and eyes. ( Also known as petichiae) My chest and abdominal myuscles were sore from so much wretching. Physicians estimate that only 1-2% of pregnant women experience this severe an early complication to pregnancy, but if you do, that's not much comfort. Women may also be unable to tolerate certain smells. They may be unable to cook, and they may be unable to drive or ride in a car without vomiting. Of course, this makes working outside the home rather difficult also.
Prior to the 1950s, before we had so many wonderful hormonal radioimmunoassay tests which could better demonstrate hormonal upheavals, some physicians thought that a woman experiencing hyperemesis gravidarum may have been psychologically rejecting her pregnancy. Now, it is known that this is not true. This is a gastrointestinal complication of pregnancy of hormonal origin. Also prior to the 1950s, before we had really excellent intravenous replacement capability and could replace not only fluid but the correct complement of lost electrolytes, some women were actually delivered of their fetus in order to save their lives. (Yes, therapeutic abortion has been performed a long time in order to save a woman's life.) A few women died of renal failure following a failure to adequately treat this sometimes challenging complication. Some women experience some degree of HG with each pregnancy, and others are bothered by it only in one pregnancy. Sometimes, women who carry multiple babies are troubled by this, because they may have multiple placentae which translates to additional hormone levels.
When I was 24, and pregnant with my first child, I too developed hyperemesis gravidarum. It was a bewildering time. Prior to the pregnancy, I think I had vomited perhaps five times in my entire life, and I absolutely hated to. I thought of myself as a nurse with an iron stomach who could see anything, and not wretch. Then, all of a sudden, my joy about a new baby was dashed with worry. I was about seven weeks pregnant when I couldn't keep anything down. I tried not eating until I got to work, and vomited anyway. I tried crackers on arising. (Those are hard to vomit !) I could vomit water with no trouble at all. In those days I was fairly slim, and I lost five pounds in no time. I was hospitalized for a first time, within the first week of my hyperemesis. Finally, I was hydrated and they had a dietician come to see me to make some suggestions as to how to work with this, and I was released. A week later I was back in just as dehydrated as I had been before. This revolving door of hydration, feeding me bananas, releasing me, and my becoming dehydrated and ketotic again and again, happened a total of 11 times that pregnancy. My doctor, trying to be efficient and thorough, did a lot of other testing in order to make sure that nothing else was going on with me. He never did establish any additional diagnoses. It ceased for me, only somewhere in the mid second trimester. I was one of the lucky ones though. Some women continue to have the symptoms of HG throughout their entire pregnancy. There are several drugs that have been used to slow vomiting, and they work with some degree of effectiveness. Still, great care needs to be taken while taking any drug, especially in early pregnancy.
I went on to have three more full term pregnancies, and only two of those had a small amount of normal levels of morning sickness. In my case, when my body finally became accustomed to the hormones being produced by a functioning placenta, I didn't react by vomiting anymore.
Recent studies indicate that at least some women who have HG also suffer from Helicobacter pylori. Since I had myself tested for this when I returned from Russia, where it afflicts 90% of people, and I did not have it, it was not a factor in mine.
If you ever have a daughter, a daughter-in-law, a friend, a neighbor or anyone else who has this nasty complication, please offer any support you can. Sending some ginger ale is a nice gesture, whether she will be able to drink it or not.
I hope Katherine the Duchess of Cambridge is feeling better soon. She has my sincerest sympathy with regard to her HG.
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| In the end, it's all worth it. (Photo: hgkaren.blogspot.com This is a baby who is a product of a pregnancy with HG) |
