Evidence-based care for patients with HG
At The Morning Sickness Clinic, we follow guidelines released by ACOG as well as The Hyperemesis Education and Research Foundation to treat patients with HG and severe morning sickness. We provide accessible, quality care that’s covered by insurance, including Medicaid. We follow our patients very closely, getting HELP scores (HG severity scores) every few days via our app, and adjusting their treatments as needed.
Send your patients to our website, we’ll take care of the rest
We will see your patients with hyperemesis gravidarum, give infusions of IV fluids, antiemetics, and vitamins, and get labs as indicated. Our protocols are based on current ACOG and HER Foundation recommendations. For pregnant patients with NVP and HG, we offer all the care of an ER, within the comfort of our clinic. Often we are able to keep our patients out of the ER and hospital and off of home health entirely. In the event that they need hospitalization, we will help arrange a direct admit. We do not require referrals. Simply send patients to our website for booking and we’ll get them into clinic within 48 hours. If you want to get a patient in ASAP, text/call the clinic directly at 205-772-9595.
Hyperemesis Gravidarum and genetics
A genome-wide association study (GWAS) by a team of researchers at the Keck School of Medicine of USC and the Hyperemesis Education and Research (HER) Foundation linked the placenta and appetite hormone gene GDF15 to hyperemesis gravidarum. (BJOG) “For generations, it’s been thought that HG was either psychological in nature or caused by the hCG pregnancy hormone, so this breakthrough leads us in a new direction,” said Marlena Fejzo, PhD, a faculty researcher at the Keck School of Medicine and the paper’s lead author. “Our study provides compelling evidence that abnormalities in the GDF15 gene and the protein it codes for are the main cause of HG.”
We follow the HER Foundation protocals: Effective HG treatment requires multiple approaches and IV fluids. // HER Foundation HG Treatment Protocols // Treatment Algorithm for managing hyperemesis gravidarum (HG) and preventing HG complications
IV Fluids and Antiemetics
Your patients will have a face-to-face or telehealth visit with Dr. Housholder, an emergency physician, and receive IV fluids, antiemetics, H2 blockers/PPIs, as well as labs and IV vitamins if indicated. They will go home with a one month prescription for antiemetics, and patients can call us for refills, not you! We take all that off your plate.
Have a patient that no nausea meds are working for? It could be due to genetic variance.
99% of people have genetic variations that affect how they metabolize treatments (PubMed). If you have patients who have significant nausea and vomiting, and nothing seems to be working for them, it could be due to genetic variance.
For example, patients with a polymorphism in ABCB1 genes hyper-metabolize ondansetron, making it essentially worthless. Granisetron is metabolized in a different pathway, and will likely be effective for these patients. Some gene variations make prolongation of the QT interval more likely. Others increase the risk of serotonin syndrome with 5-HT3 antagonists and extrapyramidal effects with dopamine antagonists.
We offer pharmacogenomic testing to help determine which treatments work best for each individual patient. And we consult with a pharmacist specializing in pharmacogenomics and hyperemesis gravidarum to deliver the safest, most effective treatment possible.
We also offer iron infusions for our HG and NVP patients.
For iron infusions, we accept BCBS and Medicaid due to reimbursement issue with other payors.
No competition, and no snake oils
The Morning Sickness Clinic is not affiliated with any hospital or obstetrics clinic, midwife practice or any pregnancy healthcare providers. Staff will not promote any treatments that we do not offer in the clinic, and will not recommend any hospitals, pregnancy healthcare providers or obstetric services. You can feel safe sending your patients to us, as competition for patients will not be allowed in the clinic.
And no snake oils here, only evidence-based treatments.
What we offer
IV Antiemetics, IV fluids, IV antihistamines (for possible dystonic reactions), IV Multivitamin & thiamin ( important for HG patients), IV steroids per HER Foundation protocols, IV acid blockers, and electrolyte replacement including potassium chloride and mag sulfate.
We offer bedside point of care CMPs and UAs, as well as EKGs for significant electrolyte abnormalities and checking qTC intervals for patients requiring multiple antiemetics.
How can I get more information?
Dr. Housholder would love to come by your clinic and discuss protocols for your personal patients. From there, we will only contact your clinic if Dr. Housholder feels your patient needs hospitalization or urgent followup. Please click below to email us and request more information, or if you would like view our protocols.