www.tidewaterreview.com/features/health/sc-health-0109-hypermesis-20130109,0,7605609.story

tidewaterreview.com

When morning sickness keeps mom up all night

Acute condition can be risky for mother, child

By Danielle Braff, Special to Tribune Newspapers

7:50 PM EST, January 9, 2013

Advertisement

When pregnant Kate Middleton was whisked to the hospital last month, many people sarcastically pitied the duchess for failing to simply deal with her morning sickness like every other pregnant woman.

But Middleton — along with about 2 percent of the general population — wasn't suffering from your average morning sickness. She had acute morning sickness — aka hyperemesis gravidarum. Most women who have it lose at least 5 percent of their body weight and have unrelenting vomiting and nausea day and night.

Ann Marie King, of Virginia, quickly went from 130 pounds to 105 when she was pregnant with her son, and she nearly lost her baby. She said hyperemesis is not a matter to take lightly.

"Hyperemesis hit me like a bomb five weeks into my pregnancy," says King, who co-founded the Hyperemesis Education & Research Foundation. "At the onset, I was up all night and unable to eat more than a slice of bread for days — and no liquid would stay in my body more than two minutes. Little did I know that this was only the beginning of a serious pregnancy condition that would require multiple hospitalizations and deprive me and my child of nutrition for more than six months."

King vomited at least a dozen times a day, resorted to a feeding tube, and was on home health care for months. But when she contracted a staph infection via her feeding tube, she and her baby nearly died.

Her acute morning sickness didn't go away until the moment she gave birth to her son, who despite living with little nourishment for the entire pregnancy was a healthy 7 pounds, 2 ounces.

The doctors advised King to not get pregnant again, because since she had hyperemesis once, she would be more prone to having it again — and the condition typically gets worse with each pregnancy.

Just as doctors don't quite understand why some women suffer from morning sickness or other pregnancy conditions, they don't know why some women have acute morning sickness, said obstetrics and gynecology Dr. Mary Jane Minkin, a clinical professor at the Yale University School of Medicine.

One theory, Minkin said, is that the pregnancy hormone HCG is partially responsible. Women expecting twins have a lot more HCG, and they tend to have more morning sickness than women expecting one child. Women who have a molar pregnancy, which makes the placenta bigger than normal, also seem to have more hyperemesis.

"But all that being said, we really don't know. It usually gets better by the end of the first trimester," Minkin said.

While the condition isn't a problem on its own, it may lead to dehydration which can cause serious heart and kidney problems for the mom, and poor nourishment for the fetus, said obstetrics and gynecology Dr. Philip Darney, a professor at the University of California at San Francisco.

What to do

Anyone who thinks she may be suffering from acute morning sickness should contact her doctor, who can prescribe anything from anti-nausea drugs to an IV to help counteract the hyperemesis. In extreme cases, one obstetrician said, the doctor may advise terminating the pregnancy.

sunday@tribune.com