Treatment
Date: 2003-02-06

Question:
Hi there, First, thank you for taking the time to read this email from a terrified woman. The reason I'm terrified? I'm terrified that if I get pregnant again it will be as awful as the first time. My questions are 1)what are the chances of repeat severe HG? and 2)Are there any new drugs on the market that may have a greater effect on my HG. Here's my history if you need it to compile some kind of an answer:

I got pregnant(pg) in Oct 2, 2000 when I was 27 yr old. Great marriage of 6 years and wonderful support network. I found out I was pg Nov 9, 2000 at 6 weeks gestation. I started vomitting around the middle of Nov. and didn't stop until I delivered at 40 weeks + 5 days. My mother and sister do not have a history of HG in any of the 3 pg they each had. I was immediately started on Diclectin 2 at bedtime, 1 in am and 1 at lunch(this seemed to have no effect) and I weighed about 140 lbs and am 5'7" tall. By my 9th week gest. I had been hospitalized twice as an outpatient for IV rehydration and finally admitted. I was given IV Gravol, IM Stemitil, and IV Phenergan over 2.5 weeks, none of which helped. I would vomit if I moved my eyes or body, at most every smell, could not even shower myself as I would convulse with dry-heaves. Movement especially seemed to set me off. My doctor tried distraction and even tried to hypnotize me. Finally, I had lost so much weight (I think about 20-25 lbs) they airvac'd me to a larger centre (Royal Alex in Edmonton). There I was put on more IV Gravol and started on Chlorpromazine and Cogentin (I had ptaylism very bad, losing almost 1000cc per day of saliva). I began to bleed from the force of my dry-heaves, but it resolved. I was nearly put on TPN at about 22 weeks, but my weight managed to finally stabilize.

I was sent home with that stabilized weight an was not hospitalized again for the remainder of my pg. However, I continued to have constant nausea and vomitted many times in the day. I was unable to work my entire pg and my husband had to take a lot of time off, and my mother cared for me when he could not. It not only exhausted me physically, but emotionally as well. I had post partum depression I attribute to the fact that I stopped the Chlorpromazine cold turkey as I was not instructed any differently.

I now have a 18 month old daughter and think I am insane for even contemplating another pg, yet I want another child in a year or so. If I do become pg, I think I will fly straight to you NVP clinic!!!!!! Any insight would be greatly appreciated!

Answer:
No two pregnancies are alike. You might not experience symptoms to the same degree a second time. However, if you do, it is important to start treating NVP immediately at the first hint of nausea. Talk to your doctor about using Diclectin. Other treatments are also available and should be discussed with your doctor.

Also, some women find it helpful to start taking Vitamin B6 BEFORE they get pregnant. Again, talk to your doctor about appropriate supplementation. Finally, bear in mind that a stomach bacteria (H Pylori) can be active during pregnancy and cause similar symptoms which require different treatment. For more information, please call the NVP Helpline at 1-800-436-8477.