What is HG, and how can I spot it?
Nausea, with or without being sick, is very common in pregnancy. It is estimated to effect up to 80% of women[1]. However, if this is prolonged, and the nausea or sickness is severe, this could be a sign of a condition called hyperemesis gravidarum.
Hyperesmis gravidarum, or HG, is a condition which affects around 1.5% of pregnancies in the UK every year. At worst it can be life threatening, and it has been reported that up to 10% of women terminate wanted pregnancies because the symptoms are so severe. There is also a higher incidence of depression, both during pregnancy, and after the birth.
Treatment will be more effective the earlier it is given; however, historically many women have experienced a delay in diagnosis. As of 2016, the RCOG developed the first UK guidelines, which it is hoped will bring more clarity to both doctors and the general public.
Symptoms and Diagnosis
The main symptoms of HG are prolonged and severe nausea or vomiting. Other symptoms include an altered sense of smell, and low blood pressure when standing – so you might feel light headed. It is important to seek help, so any other conditions which could be causing these symptoms can be ruled out.[2]
Treatment
If you are diagnosed with HG, the first stage of treatment will try and manage the symptoms, so that women can stay at home. There are medications which can help manage the symptoms of HG, including anti-emetic (anti-sickness) medication, and vitamins. If this does not work, you might need to visit hospital for treatment, including intravenous fluids to ensure you are well hydrated. For a small number of women, this will not adequately control the condition, and they may need to be admitted as an impatient for appropriate management.
New research
There is a new study from the University of California, which proposes that HG is a physical illness, linked to two genes, GDF15 and IGFBP7.[3] It is very early stages; however, a next step will be to see whether protein levels of GDF15 and IGFBP7 can be altered safely within pregnancy. [4] The hope is that this could lead to new safe medication, and perhaps be able to stop severe HG from happening altogether.
To build on this work, scientists from Kings College London and Guy and St Thomas’ Hospital are launching a four year study, to better understand genetic causes and hormonal changes. They hope the new insights they gain could lead to new treatments for the condition.
Links
Pregnancy Sickness Support:
Recruitment for new study?
RCOG Guidelines:
NHS Guidelines:
Recent Βι¶ΉΤΌΕΔ report into HG
[2] The RCOG guidelines outline a system, which should be used, to determine whether or not an individual has HG. A diagnosis of HG can be made when there is prolonged nausea and vomiting with more than 5% pre-pregnancy weight loss, dehydration, and electrolyte imbalance.
