Hyperemesis gravidarum (HG) is a life-altering condition that goes far more than typical “morning sickness.” For up to 10.8% of pregnant women, HG is a relentless cycle of nausea, vomiting, and exhaustion, leading to weight loss of over 15%. The repercussions for both mother and baby are profound: preterm birth or pregnancy termination, postnatal depression, maternal suicide, neurological developmental issues, preeclampsia, organ damage, and more.

Yet, despite its impact, HG remains underdiagnosed and undertreated due to a lack of training and adequate care settings. Many women only receive care when they’ve reached their breaking point, and Harmonia is determined to close this gap in care.

Understanding the Spectrum: NVP vs. HG

Nausea and vomiting during pregnancy (NVP) vary widely in intensity. For most women, symptoms are mild and subside after the first trimester. For those with HG, however, the unrelenting severity disrupts every aspect of life. ER visits become routine, and HG ranks as the leading cause of hospitalization in early pregnancy.

Some practitioners view HG as an extreme form of NVP, whereas others recognize it as a distinct condition with genetic roots. Recent research, including findings from Dr. Marlena Fejzo, Chief Scientific Officer at Harmonia, reveals that women with HG often have naturally lower levels of GDF15, making them hypersensitive to the elevated levels of GDF15 that occur during pregnancy. This may drive severe nausea, adding new understanding to HG’s physiological impact.

But despite these advancements in understanding, the diagnosis of HG remains inconsistent. Standardized diagnostic tools like the HELP Score exist but are underutilized. Most clinicians rely on subjective assessments or wait until symptoms become unbearable before intervening. This lack of standardization delays intervention, prolonging the suffering of patients who need immediate care.

Challenges Treatment for HG

Even after diagnosis, standard pregnancy guidelines, such as ACOG recommendations, only provide a loose framework for managing HG, meaning that clinicians may approach treatment differently. Current treatment generally involves a combination of IV fluids, antiemetic medications, and nutritional support. However, treatment usually starts with lifestyle changes and only progresses to medical interventions when symptoms become severe.

This “wait-and-escalate” model is ineffective. In reality, 100% of diagnosed HG cases eventually involve prescription medication or hospital treatment, yet we continuously fail to offer patients the treatment they will ultimately need early on. Moreover, as symptoms often persist throughout pregnancy, ongoing support is necessary yet rarely provided, resulting in 60% of HG cases requiring multiple hospital admissions.

The impact of the delay in treatment and frequent ER visits is four-fold. For mothers, untreated HG jeopardizes physical and mental health. For babies, it increases the risk of preterm birth and neurodevelopmental challenges. For healthcare providers, it adds to resource burdens. And for the economy, it represents a $3 billion annual expense in the US alone.

So how can we do better for patients, providers, and the healthcare system as a whole?

Harmonia’s Collaborative Care Model

We can rewrite the story surrounding HG, and it starts with offering early, ongoing, patient-focused care. Harmonia’s innovative model offers precisely that, addressing HG in the first trimester and providing targeted care throughout pregnancy. By treating HG early and consistently, our model reduces emergency room visits by 95%.

Harmonia’s outpatient services in our new state-of-the-art treatment center in New Jersey include proprietary infusions, electrolyte replacement, antiemetics, and lab management. This ensures that patients receive necessary treatments from early pregnancy and throughout, for as long as required. Care is managed through a shared framework, relieving OBGYN practices of the pressure to address every HG complication while ensuring a collaborative approach.

While patients benefit from fewer hospitalizations and fewer symptoms, OBGYNs feel more supported, allowing them to focus on overall prenatal care. For healthcare systems, this approach eases the strain from HG-related hospitalizations, dramatically lowering care costs by 90% and overall economic burden by 94%.

Looking Forward: A Vision for HG Care

Feedback from OBGYNs working with Harmonia highlights the impact of specialized care and its fundamental need in the future. All surveyed clinicians agreed that dedicated HG treatment centers are essential, and 100% stated they would refer patients to our facility.

HG is complex and resource-intensive for providers, requiring more than traditional “morning sickness” treatments, yet Harmonia’s collaborative model offers practitioners a lifeline. With innovative treatments and early interventions, Harmonia delivers effective care for women with HG so that OBGYNs don’t have to.

Together, we can turn severe nausea and vomiting into a manageable condition, transforming pregnancy back into the joyous experience it’s meant to be, both for providers and for moms-to-be.