HYPEREMESIS GRAVIDARIUM -- EXCESSIVE VOMITING DURING PREGNANCY
I am considering getting pregnant again (I have a 6-year-old daughter), but I can't seem to find any information on this condition. When I became pregnant with my daughter, I had hyperemesis gravidarium for the duration of my entire pregnancy (from about 6 weeks on through delivery). I lost 13 pounds in my first trimester, had ketones in my urine, was severely dehydrated and on IV's, etc. Also, during the last month of my pregnancy, I developed preeclampsia and had to have an induced delivery. Naturally, I'm kind of gun-shy about going through all that again! My obstetrician treated me with Compazine (first suppositories, then pills) which is an antipsychotic in addition to being an antiemetic (I didn't have any medical problems prior to the pregnancy). It gave me terrible side effects (blurred vision, inability to concentrate, twitching muscles, inability to sleep, etc.) Are there any new treatments or preventatives for hyperemesis? I'm afraid to become pregnant again because I'll have to take the whole 9 months off of work if I have this condition again! Are there ANY treatments besides Compazine? I really want to have more children, but I almost died during my last pregnancy, because I couldn't get to the doctor (the HMO wouldn't make me an appointment because they said "vomiting is normal, eat crackers." By the time I got in to see the doctor, I was so dehydrated that they put me in the hospital.) Are there any doctors in the MD/DC/VA area that specialize or have experience with treating hyperemesis? I would also love to hear from those of you who have been through this with suggestions! Thanks -- Andi (Mom of Kira, 6)
Hyperemesis carries a very good outlook with EARLY treatment. Having experienced delay in treatment in the past, you are presenting your concerns to care providers who can be sensitized to your circumstance.
I am not aware of good information on recurrence of hyperemesis. The problem is that patients who have had problems in the past are often given medicatio so quickly that it is hard to know whether the problem is prevented or it was not destined to occur a second time.
Besides the widely known diet/avoidance of food odor recommendations, a non-drug therapy is acupuncture. Wrist bands are sold for motion sickness: they have benefit with pregnancy-associated nausea and vomiting.
Oral anti-emetics (durgs that block nausea/vomiting) are the backbone of treatment. Most are in this class that you have labeled as an antipsychotic and the side effects can be very annoying.
The vitamin, pyridizone (B6), has anti-emetic properties and is helpful to some patients experiencing nausea from cancer treatments.
Finally, Linda has given you references to therapy with corticosteroids. This group of drugs is safe for the baby. They do have sigificant possible side effects for Mom, including changes in bone, stomach ulcer, blockage of the normal stress response, and suspectibility to infection.
Pre-conception discussion with the provider who will manage your pregnancy so that you have a rapport and a plan of management is the starting point in therapy.
Keywords: hyperemesis gravidarum
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