Kate has Middleton has hyperemesis gravidarum. What is it?

THE Duchess of Cambridge, Kate Middleton, is suffering acute morning sickness or ‘hyperemesis gravidarum’. What is it exactly?

Prince William, Duke of Cambridge and Catherine, Duchess of Cambridge, leave hospital where The Duchess was being treated for acute morning sickness (hyperemesis gravidarum) when pregnant with George. Picture: Indigo/Getty Images

THE Duchess of Cambridge, Kate Middleton, is suffering acute morning sickness or ‘hyperemesis gravidarum’. What is it exactly?

Hyperemesis gravidarum is a potentially dangerous type of morning sickness which tends to be more common among younger women, in women pregnant for the first time, and in multiple pregnancies.

Medical expert Dr Cindy Pan shares the morning sickness essentials for severe sufferers.

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Q. Can morning sickness ever be all that serious? What can be done for really severe cases?

A. Really severe morning sickness, known as ‘hyperemesis gravidarum’ can be extremely serious and in fact in the days before the advent of intravenous rehydration many women actually died of it. The most famous case of this was author Charlotte Bronte who died of severe nausea and vomiting just four months into her pregnancy way back in 1855.

Of course, the term ‘morning sickness’ is quite a misnomer given that less than two per cent of women experience nausea in the morning only and 80 per cent report nausea throughout the whole day.

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Catherine, Duchess of Cambridge, and Prince William, Duke of Cambridge, the day after giving birth to George. Picture: John Stillwell/WPA-Pool/Getty

For most women the condition is uncomfortable but generally mild and self-limiting, however for around one to three per cent of women the symptoms are disabling, with intractable vomiting leading to dehydration, electrolyte and acid base disturbances, weight loss and nutritional deficiency.

Quality of life, ability to work, do housework and look after children are all significantly adversely affected and up to 60 per cent of women with hyperemesis gravidarum develop depression with many considering and some even going through with termination of pregnancy at the prospect of continued nausea and intractable vomiting.

The most important thing is to recognise that really severe nausea and vomiting warrants prompt medical assessment and if necessary hospital admission for intravenous fluids. It is not something you should just put up with and try to get through; the sympathy, tea and tissues of well-meaning friends and rellies are all very well but unfortunately not enough.

Certainly try lifestyle measures — such as eating most when you feel best or are hungry, avoiding cooking, lying down when nauseated, drinking small amounts often and eating small amounts frequently, avoiding fatty, spicy or rich foods and trying salty foods or sucking barley sugar or boiled sweets — but generally these measures alone will only get you so far.

While many Mums are reluctant or fearful about taking medication during pregnancy, it is actually well warranted and necessary in cases of hyperemesis gravidarum.

Your doctor may recommend Vitamin B6 or a drug called metaclopromide three to four times daily. A sedating antihistamine may also be suggested which is best used at night due to drowsiness.

For women who continue to suffer nausea despite these measures, prochlorperazine or oral prednisolone may be prescribed. Ondansetron is another highly effective drug for nausea however it is often reserved as a last resort due to high costs compared to other medicines. Ginger, in the form of tea, biscuits, sweets or in dried and candied form is thought to be beneficial; although it remains unproven, it should be fairly harmless if taken in sensible quantities.

Acupuncture and acupressure have also been tried for hyperemesis, with varying results. Although it remains unproven, manual application of acupressure — using the fingers or an elasticised band to press over the specific pressure point — should be harmless and without cost or side effects.

This article first appeared in the Body and Soul liftout.

Originally published as Kate has Middleton has hyperemesis gravidarum. What is it?