Preemptive treatment of severe morning sickness decreases suffering for moms-to-be

Hyperemesis gravidarum is a severe form of morning sickness which affects two percent of pregnant women. HG is marked by persistent nausea and vomiting, and can begin early in the first trimester, continuing well into the second, third or even up to giving birth. Women who suffer from HG become severely dehydrated, and often end up in the hospital on IV fluids. Recurrence rate for women who had HG in their first pregnancy is 75-85 percent in subsequent pregnancies, and the condition can be fatal.

Previous treatment for HG was to administer medication (Diclectin in Canada, Bendectin in the US) at the onset of symptoms, but this course of treatment provided little, if any, relief.

Drs. Gideon Koren and Caroline Maltepe, of The Hospital for Sick Children in Toronto, ON, Canada, divided 59 women with a history of HG or severe morning sickness into two groups: one would begin taking Diclectin as soon as the pregnancy was discovered; the second group would begin treatment at the first sign of nausea.

They found the group receiving treatment before the onset of symptoms, had a significant decrease in risk of severe nausea and vomiting.

"This is the first time there is an answer," said Dr. Koren. "Women who have experienced hyperemesis are so traumatized by it, they are afraid of a second pregnancy."

Dr. Koren, who with Dr. Maltepe runs a severe morning sickness counseling program at The Hospital for Sick Children, says the drug used to treat HG is safe to take throughout pregnancy or even before conception.

Koren and Maltepe conducted the study at The Hospital for Sick Children, The Motherisk Program/Division of Clinical Pharmacology and Toxicology, Toronto, ON, Canada.