Bitter Perception in Women with and Without a History of Hyperemesis Gravidarum

LEARNING OUTCOME: To determine if women with a history of hyperemesis gravidarum have a higher response to bitter stimuli than parous women without severe nausea. Humans show an innate dislike of bitter taste. This dislike may aid in the avoidance of bitter poisonous substances. Therefore, we were interested in whether heightened bitter taste perception plays a role in the excessive vomiting seen in women who suffer with hyperemesis gravidarum (HG). Bitter perception is heightened in genetic supertasters (measured by response to 6-n-propylthiouracil or PROP) and can be altered in dysgeusia. Dysgeusia may be a phantom sensation or persistent taste in the mouth. We recruited women who had a history of hospitalization for HG and those without severe nausea and vomiting during pregnancy. Two groups of women were formed based on a vomiting score (vomiting frequency and severity over the course of pregnancy); 15 scored in the high vomiting group and 16 in the low vomiting group. Bitter taste response was measured by: 1) bitterness of PROP impregnated paper; 2) bitterness of .001 M quinine hydrochloride (QHCL) applied to areas of taste nerve innervation. Subjects reported the presence of dysgeusia and the history of taste-related pathology. The perceived bitterness of PROP was similar for both groups. In chi square analyses, women with high vomitting reported significantly higher bitter perception in the back of the tongue (p