The Duchess of Cambridge, Catherine Middleton, is pregnant with her and Prince William's third child. Amid all the excitement of the growing royal family, a less pleasant subject is coming to the fore as a result of one peculiarity of Kate's pregnancy–hyperemesis gravidarum (HG).
Middleton suffered from the debilitating condition throughout her first two pregnancies, and unfortunately she is experiencing symptoms again. HG causes severe nausea and vomiting and makes it difficult for women to consume adequate amounts of food and fluid.
How serious is hyperemesis gravidarum?
Doctors sometimes refer to HG as extreme morning sickness. While 70 to 80 percent of pregnant women experience morning sickness to some degree, only about 0.5 percent of pregnant women suffer from HG.
The condition is not simply unpleasant, it can be dangerous to the mother and fetus. This extreme nausea can lead to dangerous weight loss and eventual lack of nutrition for both the mother and baby.
Amy Magneson, MD, FACOG, assistant clinical professor at Columbia University told Refinery29, "Hyperemesis is a magnified version of morning sickness, in which [pregnant women's] bodies have trouble distinguishing hunger for nausea. Eating doesn't make the nausea go away ... they try to eat small meals, but most of the time, they cannot even keep water down. This causes dehydration and more hunger, creating a vicious cycle. Women with HG can start to lose weight—they are essentially starving."
What causes HG and how can you avoid it?
Doctors still do not know the exact cause of HG, but they believe that genetics and hormonal changes are major factors. According to Magneson, carrying twins increases the chances for experiencing the condition, which has led to rumors that Kate and William may have twins on the way.
However, having the condition in a previous pregnancy is also a predictor. Since Middleton had HG during her pregnancies with George and Charlotte, there is no reason to assume she is carrying twins.
Unfortunately, there is no known way to avoid HG.
The good news? The condition may be a sign of a healthy pregnancy. Dr. Peter Bernstein, a maternal-fetal medicine specialist at Montefiore Medical Center in New York, told TODAY, “It’s a sign that the placenta is making more hormones. ...The mother may be miserable but [she's] less likely to have a miscarriage.”
Is there a cure for the condition?
There's no cure for HG, but there are treatments. Giving the mother fluids through an IV can help rehydrate her and lessen her nausea. Alternate therapies such as acupuncture may have a therapeutic effect but are not clinically proven.
Doctors are hesitant to give anti-nausea medication to pregnant women because the effects on the baby are not well studied. Still, in extreme cases, doctors have treated women suffering from HG with ondansetron (also known as Zofran) with no evidence of adverse impacts on their children.
Kensington Palace announced Middleton's pregnancy because her treatment plan needs to include plenty of rest, which meant canceling future engagements so doctors can properly care for her.
HG is a serious and debilitating condition, but thanks to modern medicine, it is rarely life threatening to mother or baby. We're lucky to live during an age in which doctors can tackle many problems before they becomes too serious.
We wish the best to the duchess as she copes with this difficult condition and rests up to bring a new baby into the world!