Understanding Sis Gravid Arum

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Overview Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with: • • • • •

loss of greater than 5% of pre-pregnancy body weight (usually over 10%) dehydration and production of ketones nutritional deficiencies metabolic imbalances difficulty with daily activities

HG usually extends beyond the first trimester and may resolve by 21 weeks; however, it can last the entire pregnancy in less than half of these women. Complications of vomiting (e.g. gastric ulcers, esophageal bleeding, malnutrition, etc.) may also contribute to and worsen ongoing nausea. Understanding Hyperemesis There are numerous theories regarding the etiology of hyperemesis gravidarum. Unfortunately, HG is not fully • Theories understood and conclusive research on its potential cause • Diagnosis is rare. New theories and findings emerge every year, • Treatments substantiating that it is a complex physiological disease • Risks likely caused by multiple factors. • Complications • Impact Diagnosis is usually made by measuring weight loss, checking for ketones, and assessing the overall condition of the mother. If she meets the standard criteria and is having difficulty performing her daily activities, medications and/or other treatments are typically offered. Current HG Poll Treating HG is very challenging and early intervention is critical. HG is a multifaceted disease that should be In pregnancies where approached with a broad view of possible etiologies and you lost 10% or more complications. When treating mothers with HG, of your prepregnancy preventing and correcting nutritional deficiencies is a weight, have any of high priority to promote a healthy outcome for mother your children over 3

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presented at a May 2002 conference on Understanding and Treating Nausea and Vomiting of Pregnancy, sponsored by the National Institute of Child Health and Human Development and The Office of Rare Diseases, National Institutes of Health, proposed that its possible use in the U.S. be studied.

The ingredients of diclectin are the same as those of bendectin, a drug used to treat nausea and vomiting in pregnancy in the United States from 1956 to 1983. After numerous lawsuits were filed claiming bendectin caused various birth defects, the drug’s manufacturer voluntarily withdrew it from the market, citing rising legal costs and negative publicity. However, despite bendectin’s becoming the most studied drug in regard to pregnancy, no research has ever demonstrated an increased incidence of birth defects in association with the use of bendectin. In fact, the Food and Drug Administration (FDA) has determined that bendectin was not withdrawn from the market for reasons of safety or effectiveness. Other antihistamines have been used to treat nausea and vomiting in pregnancy, sometimes in conjunction with diclectin. These include dimenhydrinate (Gravol), hydroxyzine (Atarax), and promethazine (Phenergan). However, these drugs have not been studied thoroughly in pregnant women, and their FDA approval labeling cautions that they are not approved for pregnant or nursing women. These drugs have been studied in pregnant women and have not been shown to increase the risk of congenital anomalies. Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site. For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office: Tollfree: (800) 411-1222 TTY: (866) 411-1010 Email: [email protected] For information about clinical trials sponsored by private sources, contact: www.centerwatch.com

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