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Hyperemesis Gravidarum: All Sufferers Should Be Offered 'Royal Standard' Of Sickness Treatment

'For far too long women were expected to ‘put up’ with their symptoms.'

05/10/2017 00:03

All women suffering from hyperemesis gravidarum (HG) should be offered the “royal standard” of pregnancy sickness treatment, charities and medical experts are urging.

A conference hosted by Pregnancy Sickness Support (PSS) and the British Pregnancy Advisory Service (bpas) today [Thursday 5 October] will explore the latest research on HG and what treatment all women suffering from the condition should be offered.

Despite growing public awareness, many are still being denied safe, effective treatment. More than half (53%) of women with the condition have difficulty accessing treatment - without which they can develop severe dehydration and malnutrition.

“HG can be an extremely serious condition, and for far too long women were expected to simply ‘put up’ with their debilitating symptoms,” said Clare Murphy, director of external affairs at bpas. 

“Women should have access to the full range of treatments available and, above all, be trusted and believed when they describe a level of nausea and vomiting affecting their ability to get on with their everyday lives.” 

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Catherine Nelson-Piercy, professor of obstetric medicine and consultant obstetric physician at St Thomas’ Hospital, London, who is taking part in the conference, believes spreading awareness of available treatments and research into the condition is “vital”, so delegates can take it back to their own area of practice.

“Appropriate treatment can work but is not always instigated, maintained or escalated,” she said.

The charities state that HG has historically been “under-researched and under-funded”, which means the effects it can have on women and their families have not been sufficiently recognised, amid perceptions that it is “just” morning sickness. 

At the conference, experts will warn that HG has a profound effect on women’s mental health – potentially extending beyond their pregnancies –stressing the need for treatment to incorporate psychological support.

Researchers will also highlight evidence that HG can lead to social isolation, in part due to stigma and fear of humiliation, depression, anxiety, and even thoughts of death and suicide. 

PSS chairperson and conference organiser Caitlin Dean said: “Care and treatment options for Hyperemesis Gravidarum (HG) have improved massively in the last few years and research into the condition is finally attracting attention and tentative funding.

“The mental health effect of this condition can be profound and doesn’t always end when the baby is born but can persist for years after. HG can limit families and alter the trajectory of a woman’s life.”

This is something mums have previously expressed to HuffPost UK. Mum Alexandra West, 28, from Sussex, who suffered from HG in her third pregnancy, told us: “I was mentally and physically drained. I couldn’t eat, drink or sleep. I was so fed up and negative about everything in life.

“It made me feel very negative towards the pregnancy. I hated the way I felt and looked. I felt if I couldn’t handle the pregnancy, how would I cope with a baby?”

The exact causes of HG are unknown, but researchers speaking at the conference are actively pursuing the genetic link which they hope will one day enable clinicians to predict women’s likelihood of developing HG, and also enable the development of new treatments for the condition.

Marlena Fejzo, professor of research on Hyperemesis Gravidarum at UCLA and USC, said: “Mounting evidence supports a genetic link to HG. If your sister has HG, you have a 17-fold increased risk of also having HG.

“The gene ‘RYR2’ may play a role in a woman’s likelihood of developing the condition. Through our research, we have been able to identify a mutation in this gene which was present in four sisters who all suffered from HG, but absent in their female relatives who did not have the condition. 

“We are in the process of uncovering other genetic links to HG in order to solve the mystery of what causes this devastating pregnancy disease. We hope to report our progress soon.”

As research on this area continues to develop, bpas is calling for women with symptoms of HG to receive information on all treatments available.

“There are medications that can be used in pregnancy, including the first 12 weeks, to help improve the symptoms of HG,” the NHS Choices website states. “These include anti-sickness (anti-emetic) drugs, vitamins (B6 and B12) and steroids, or combinations of these.

“Evidence suggests that the earlier you start treatment, the more effective it will be. You may need to try different types of medication until you find what works best for you.

“If your nausea and vomiting cannot be controlled, you may need to be admitted to hospital. Treatment can include intravenous fluids, which are given directly into a vein through a drip. If you have severe vomiting, the anti-sickness drugs may also need to be given via a vein or a muscle.”

More information on the programme of the conference can be found here

For more information:

Pregnancy Sickness Support charity offers help and guidance to women suffering. They have a helpline, as well as online forums, guidance, coping strategies and a wealth of information online. Call 024 7638 2020 or visit their website for more info.

The HER Foundation has lots of research, useful information and support on HG. Visit their website here

The NCT has a wealth of information on the signs and symptoms of HG on their website

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