Yes I’m going there. I didn’t want to get all topical current affairs and talk about this… but then it dawned on me – it was this time last year I was just coming out of the hell that is Hyperemesis Gravidarum (HG). So instead of talking about Kate Middleton / Duchess of Cambridge (or whatever she is now called?), whose HG has returned, I’m going to leave the poor girl out of it and talk about myself, twin pregnancy, HG and my speculations.
The truth is, HG is suddenly becoming more common now, especially in twin/multiple pregnancies. This is because HG is caused by elevated levels of the pregnancy hormone HCG (Human Chorionic Gonadotropin). During a twin pregnancy, your levels of HCG are more than double that of someone with a singleton pregnancy. For most people – this means that a lot of pregnancy symptoms are worse in multiple pregnancies.
The HCG hormone also softened my hip bones and pelvic bones so much that they grated on each other, causing the disabling pain, that is known as SPD (Symphis Pubis Dysfunction). I developed SPD at around 20 weeks and in addition to attending physiotherapy (one-to-one and group classes), I had to wear a hideously uncomfortable bandage-like belt under my clothes and could barely walk.
But yes… HG took over my life from around 7 weeks of pregnancy, to around 17 weeks of pregnancy. I had constant nausea and was physically sick mostly about 6 times per day, for between half an hour, to an hour each time. So that is at least 3 hours per day of vomit. If you break that down, over the ten weeks… that’s about 210 hours of being sick!
The low point for me was around about week 11. I felt like my body was shutting down. I couldn’t keep even a sip of water down and by this point I had completely given up food. There was no point. Eating meant that the burning in my throat was worse and when you know you can’t keep it down… what’s the point in eating it? The doctor gave me pills… which I threw up. The doctor told me there wasn’t really anything else that they could do. They only tested me for keytones once – at the very beginning. In hindsight, I should have gone back again and again until they did something, as I was really suffering.
I was so weak and my throat and stomach constantly hurt. I lost over a stone in weight and had petechiae (also known as petechial heamorrhage) around my eyes. I had increased salivation, dark urine and hyperolfaction (extreme sensitivity to odours), which meant toilets, food, feet, bins etc made me even more sick. According to this Women’s Health article on Hyperemesis Gravidarum, these are all medical problems that I would not have had if my HG had been treated. I had no energy and I tried to stay positive, but there were many times hugging that toilet that I cried for my mum. She lives a good two hour drive away and I knew there was nothing she could do to make it better so I didn’t ask her to come.
Lack of treatment of HG can cause a huge number of illnesses and pregnancy complications. There’s not enough research available, but I can’t help but wonder if my lack of treatment contributed to my HELLP Syndrome. Some research shows that both HG and HELLP Syndrome both cause severe vomiting in pregnancy. According to this research paper (abnormal liver function tests on the symptomatic pregnant patient) by Wong et al, HG is the biggest cause of abnormal liver function in the first trimester of pregnancy. HELLP Syndrome is the biggest cause (although much rarer) of abnormal liver function in the third trimester of pregnancy. Untreated, HG can, and HELLP will, cause liver failure. I find these links fascinating and wish there were some way I could be more involved in research into HELLP Syndrome, but there is not a great deal of it in the UK. It is suggested that around 5% of pregnant women suffer with HG and only 0.1% of pregnant women develop HELLP Syndrome… could it be that those 0.1% had their HG left untreated? Is there a link?
Please note, this blog post is based on my experiences, my own speculations and a large volume of research articles that I have read, but should not be treated as fact.