June 23, 1997
Severe morning sickness forcing some women to terminate planned and wanted pregnancies
TORONTO - A recent study by researchers at The Hospital for Sick Children (SickKids) has revealed that severe morning sickness is forcing some Canadian women to terminate an otherwise planned and wanted pregnancy. The survey also indicates that most of the affected women did not receive appropriate medication for the condition, even though an approved drug is available in Canada. The survey results are published in the June issue of Canadian Family Physician.
The research was conducted through the hospital's Motherisk program, a consultation and information service for women and their health care providers concerning the fetal risks that may be associated with drug, chemical and radiation exposure during pregnancy. The objective of the study was to determine whether severe forms of morning sickness are a cause for therapeutic abortion and to characterize the pattern of events.
"We interviewed 1,100 women who called the Motherisk information line during the two-month period following our advertisements seeking women who had experienced morning sickness," explains Dr. Gideon Koren, head of Clinical Pharmacology and Toxicology at HSC and professor of Paediatrics at the University of Toronto. "Of those women, 17 terminated an otherwise wanted pregnancy because of severe morning sickness. An additional 42 women considered ending their pregnancy to alleviate their severe symptoms."
Of the 17 women who terminated their pregnancy, only two were prescribed doxylamine and vitamin B6 (Diclectin) the only medication approved in Canada for nausea and vomiting in pregnancy. Nine women were recommended dimenhydrinate (Gravol) even though it is contraindicated in pregnancy.
Severe nausea and vomiting in pregnancy - termed hyperemesis gravidarum - is defined as vomiting that occurs for the first time before the 20th week of gestation and is of sufficient severity to cause weight loss, fluid electroyte and acid-base imbalances. The women who terminated their pregnancies experienced between three and 25 vomiting episodes each day, and a weight loss of between one and 18 kilograms. In addition, they lost an average of 20 days of work. For the women who continued their pregnancy despite hyperemesis gravidarum, a greater weight loss was reported, vomiting episodes were between one and 15 occurences per day, and a mean of between 64 and 74 work days were lost. The birthweight of their infants was also significantly lower than the control group.
"This study paints a grim picture of the medical management of severe nausea and vomiting during pregnancy," explains Dr. Koren. "Women who suffer from this condition are often not receiving appropriate medication. Women also expressed fear that such medication would harm their fetus, and their fears are not being alleviated."
The research was funded by the Motherisk Research Fund and Duchesney Inc.
For more information, please contact:
Public Affairs
The Hospital for Sick Children
555 University Avenue
Suite 1742, Public Affairs, First floor Atrium
Toronto,
ON
M5G 1X8
Canada
Phone: 416-813-5058
Fax: 416-813-5328