Hyperemesis Gravidarum In Second Trimester More Likely To Cause Complications

Hyperemesis gravidarum is now a household name thanks to its most famous victim, Kate Middleton. Now, research shows that hyperemesis gravidarum is not only an issue during the first trimester. If it extends into the second trimester, a new study shows, the condition is more likely to cause placental complications.

Pregnancies complicated by hyperemesis gravidarum in the second trimester of pregnancy are reportedly at a higher risk for placental complications such as placental abruption, shows a new study. The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, states that the condition — which occurs in 0.5 to 3 percent of pregnancies — can also contribute to babies born small for their gestational age.

The condition — made famous by the Duchess of Cambridge — is generally defined as severe morning sickness and includes symptoms such as lack of appetite and severe vomiting. It generally occurs before 22 weeks gestation and usually requires hospitalization for intravenous fluids. The condition is caused by high levels of the pregnancy hormone hCG.

In the new study, researchers found that placental disorders — such as pre-eclampsia, placental abruption, stillbirth, and small for gestational age babies — were more likely to be seen in women who had been hospitalized for hyperemesis gravidarum at some point in their pregnancy. The study further indicated that women who were hospitalized in their second trimester were more likely to see these complications.

“The strongest risk associations were found in pregnancies with hyperemesis gravidarum in the second trimester, when compared to pregnancies without hyperemesis gravidarum. The study found that there was a doubled risk of preterm pre-eclampsia (0.6% vs 1.4%), a threefold risk of placental abruption (0.4% vs 1.1%) and a 39% increased risk of a SGA baby (2.4% vs 4%).”

No strong risks were found between the condition and stillbirth risks, notes Marie Bolin, Department of Women’s and Children’s Health at Uppsala University and co-author of the study. Bolin states: “Our study found clear associations in the risk of pre-eclampsia, placental abruption and SGA birth in women presenting with hyperemesis gravidarum, particularly those presenting in the second trimester.

Bolin continues: “The results indicate that pregnancies with hyperemesis gravidarum in the second trimester demand an increased alertness and supervision during the pregnancy for development of any adverse outcomes associated with abnormal placentation. Further research is needed to consider the best treatment and techniques for surveying blood pressure and fetal growth in these high risk women.”

The study concludes by noting that women in their second trimester dealing with hyperemesis gravidarum should be made aware of the potential complications and should talk to their obstetrician about any concerns.

As for Kate Middleton, she has reportedly been snacking on boxes of shortbread cookies, so hopefully her appetite will return soon and the couple will have no more complications throughout the remainder of the royal pregnancy.