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Beyond morning sickness; Kate Middleton's hospitalization put focus on rare but debilitating condition.

Byline: Susan Spencer

Natalie M. Garriga Meyer, a 35-year-old commercial roofing bid coordinator from Millbury, has at least one thing in common with the Duchess of Cambridge, the former Kate Middleton.

The two expectant mothers suffer from a rare and severe form of nausea called hyperemesis gravidarum.

The duchess spent three days in the hospital to treat her condition while Ms. Meyer has been coping at home, with the strong support of her husband and mother. But Ms. Meyer had intravenous fluids administered in her certified nurse-midwife's office at Reliant Medical Group in Worcester.

"The only thing I can equate it to is when you have that lightheaded dizziness ... and then the nausea came," Ms. Meyer said. "It's constant nausea."

Ms. Meyer said the vomiting was how she found out she was pregnant. She didn't have a fever but felt ill, unlike anything she had before.

Her pregnancy is now about 12 weeks along.

Dr. Steven M. Solano, director of ob-gyn quality and safety at Reliant Medical Group, with a practice in Westboro, said that while 50 to 90 percent of pregnant women will have some degree of nausea and vomiting, hyperemesis isn't your average morning sickness.

It occurs in approximately 0.2 to 2 percent of all pregnancies.

Women who suffer from hyperemesis lose 5 percent or more of their pre-pregnancy body weight and have difficulty holding down food or liquid.

The condition typically peaks at five to nine weeks' gestation and by 16 to 20 weeks it is usually gone, Dr. Solano said, although individual cases vary.

He said that if the patient can't hold anything down, health care providers will first try IV fluids in the office and then, if necessary, hospitalization.

"We don't want these moms to get significantly dehydrated," Dr. Solano said, urging any pregnant women with severe nausea to contact her provider as soon as possible. The mother needs to able to support a healthy pregnancy.

"It's treating the mom first and then the fetus," Dr. Solano said.

Anti-nausea medication may be required too. While these medications are relatively safe, Dr. Solano said that they prefer to try other treatments first during the developmentally critical first trimester.

Ms. Meyer said she was prescribed Zofran (ondansetron), which she has to take immediately when she wakes up. "If I don't take it right away, then I'm puking for the rest of the day," she said.

She also eats a bland diet featuring plain Cheerios, which is what Dr. Solano recommends. He said small, frequent meals high in carbohydrates help. Rich, spicy or fatty foods, or foods with odors or tastes that trigger nausea, should be avoided.

Just the smell of cigarette smoke from a neighboring apartment triggers nausea for Ms. Meyer, she said.

Hyperemesis appears to have a genetic link and is more common in women who have twins. Dr. Solano said that some research has pointed to carrying a female fetus as being associated with the condition.

Ms. Meyer wouldn't be shocked to learn she was carrying twins, although she doesn't know what she's having yet. Twins run in her family. Her great-grandmother had two sets of twins and her aunt had twins.

Whether or not she's carrying on the family tradition of multiples, her pregnancy has otherwise been smooth. Ms. Meyer said, "They reassured me that the sicker you are, the better it is for the baby."

"Typically, the good news is for most people, it does go away once you're out of the first trimester," Dr. Solano said.

Ms. Meyer said that she feels validated by the awareness of hyperemesis gravidarum raised by the duchess. She no longer feels people are skeptical of this as just another bout of morning sickness.

"It exists and it's real," Ms. Meyer said. "It's debilitating and it really takes you out of the loop of everything."

Contact Susan Spencer by email at Follow her on Twitter @SusanSpencerTG.


CUTLINE: (PHOTO) Reliant Medical Group Dr. Steven Solano helps women deal with hyperemesis gravidarum during pregnancy. (CHART) Comparing morning sickness with HG

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Title Annotation:LIVING
Publication:Telegram & Gazette (Worcester, MA)
Article Type:Medical condition overview
Date:Jan 2, 2013
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