Supporting Amanda Through Hyperemesis Gravidarum Pregnancies

Pregnancy would have been a dream if Amanda Wolin had only experienced normal morning sickness. But that was not to be the case. Instead, she had severe nausea all day, to the point of hospitalization.

When Amanda, 37, became pregnant in 2020 at 33, she saw her usual OB/GYN, and things went fine. Until they didn’t.

“I started getting really, really sick and couldn’t get out of bed,” says Amanda, a partner in the law firm of Cox Castle & Nicholson in Los Angeles. “I lost 12 pounds in a month.”

Her obstetrician hospitalized her for a week and diagnosed her with hyperemesis gravidarum (HG), which typically occurs during the first trimester, and may last for the entire pregnancy.

What is hyperemesis gravidarum?

Hyperemesis gravidarum (HG) is a severe and persistent form of nausea and vomiting during early pregnancy that goes beyond the typical morning sickness experienced by many pregnant women, also known as “nausea and vomiting in pregnancy” (NVP).

The exact cause of HG is not fully understood. Still, it is believed to be related to hormonal changes in pregnancy, particularly elevated levels of human chorionic gonadotropin (hCG) (produced by the placenta and known as Gdf 15) and estrogen. Women who have low levels of this hormone before pregnancy experience more severe symptoms of HG.

What are the symptoms of hyperemesis gravidarum?

HG during pregnancy symptoms include:

• Persistent and extremely severe vomiting that can lead to dehydration and malnutrition. This may lead to a baby’s low birth weight.
• Significant weight loss, often more than 5% of pre-pregnancy weight.
• Imbalances in electrolytes, which are critical for bodily functions.
• Severe dehydration that may require intravenous fluids. Signs of dehydration include dark urine, dry skin, weakness, lightheadedness, or fainting.
• Extreme tiredness and weakness due to the inability to keep food down.
• Rapid heart rate.

What are risk factors for developing HG?

Pregnant women who have had HG during a previous pregnancy, a history of menstrual pain, sensitivity to oral contraceptives, nausea before their period, migraine headaches, allergies, high blood pressure, or are prone to motion sickness are at higher risk of HG. Women are also at increased risk if a family member has suffered the condition.

Enter Dr. Rad: pregnancy expert

During the 9th week of her high-risk pregnancy, Amanda sought the assistance of Dr. Rad, who immediately put her in the hospital for another week.

“He came up with a cocktail of drugs that reduced my nausea,” says Amanda.

In severe cases, HG may be treated with antiemetic (anti-sickness) drugs such as metoclopramide, promethazine, ondansetron, and doxylamine. Antihistamines and vitamin B6 (pyridoxine) may also be administered to decrease vomiting and allow the expectant mother to keep food down. During pregnancy, a medial professional should only administer these medications to avoid potential side effects.

Twenty-one weeks later, during her 30th week of pregnancy, Amanda learned her baby was experiencing fetal growth restriction (FGR). With this condition, a fetus is smaller than expected for the number of weeks of pregnancy.

While nothing can be done to increase the fetus’s size, close monitoring can help catch and manage any related complications. Dr. Rad monitored the fetus closely to ensure there were no complications or underlying conditions contributing to fetal growth restriction. Double-board certified Dr. Rad uses innovative 3D and 4D high-definition ultrasound technology available only in a few places worldwide.

From then on, Amanda visited Dr. Rad every week until her delivery. A healthy baby girl — Delilah — was delivered via C-section.

“I was up and standing that afternoon,” marvels Amanda.

Act 2: Amanda’s next pregnancy

Not one to be negatively influenced by past experiences, Amanda became pregnant again a little over a year later. Her first call, of course, was to Dr. Rad, who said she wouldn’t necessarily have a repeat performance of her HG pregnancy.

Sadly, not far into her pregnancy, HG did rear its ugly head, and Amanda was once again experiencing persistent and debilitating nausea. She was hospitalized two times. But this time, Amanda suffered a seizure from dehydration and had to receive IV fluids. But her spirits remained high.

“I felt so taken care of,” she says.

But, once again, Amanda delivered a healthy baby via C-section — Peyton.  Amanda was still weak from surgery and hadn’t regained her full strength. She found that taking care of a newborn and 4-year-old Delilah was too much; she needed some assistance.

Her really tough period occurred when she had a nanny care for Delilah, and her mother tended to her. “I did not think I was going to survive,” she says. At that point, Dr. Rad arranged for home health care to lend even more backup.

“If it wasn’t for Dr Rad’s support, I don’t know if I could have made it through,” says a grateful Amanda.

Now, Amanda enjoys raising her children and referring friends to Dr. Rad.

Why trust Dr. Rad with your high-risk pregnancy?

Expectant mothers with high-risk pregnancies worldwide are finding their way to Dr. Steve Rad’s Beverley Hills offices. Dr. Rad is recognized as one of the premier healthcare providers for high-risk pregnancy and maternal-fetal medicine. Los Angeles Magazine has named the doctor a top maternal-fetal medicine specialist in Los Angeles for six years running.

A maternal-fetal medicine specialist (perinatologist) receives a traditional obstetrics and gynecology education but with an additional three years of training to treat medical complications and promote a healthy pregnancy.

Call (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.

Dr. Rad offers in-home prenatal care and a fly-in program for out-of-town and international patients. He travels to patients who need him throughout the U.S. and worldwide and offers virtual consultations.