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Kate: All you need to know about Hyperemesis Gravidarum?

Smile Kate, the Telegraph says it might be a case of  third and forth in line of succession ...
Julian Bray comments: As a simple handy guide for the thousands of well-wishers, journalists and broadcasters from all over the world,  doorstepping the private London hospital where the Duchess of Cambridge is spending an uncomfortable few nights, just what is this [phonetic] hyper-em-esis gravid-arum all about? 

It's generally recognised that 'Morning Sickness' is fairly routine or a common complaint among pregnant women, and is sometimes enhanced when twins are expected, or IVF in some form, had been employed. In numerical terms, for most, a temporary but minor nuisance. For the chosen few, hit with the very serious and distressing enhanced condition, as experienced by the Duchess of Cambridgeshire, the sickness can strike at any time of the day or night, and may continue for several months throughout the course of the pregnancy. 

Simply for women with hyperemesis gravidarum, the problem is serious  - and unrecognised or untreated potentially dangerous. All too often pregnant females do not seek medical assistance, thinking it is just a condition associated with a normal pregnancy, but their vomiting is extreme, and as such no food or liquid can be kept down. This is where medical intervention usually in the form of a 'drip' is introduced to keep fluid levels up. Although morning sickness usually passes as the pregnancy progresses hyperemesis gravidarum can last beyond past the first third or trimester of a normal pregnancy. It should, say doctors, pass by week 21 of pregnancy, but can as we have seen last much longer.

Turning to the symptoms of hyperemesis gravidarum. Females with hyperemesis gravidarum will from time to time experience tiredness and possibly dizzy spells, they will probably  lose some 10 per cent of their body weight weight but clearly not in a 'nice'way. The condition has a number of side effects for example they may find they're passing urine less often. The real danger say most medical professionals is that of dehydration, this is a condition faced daily by aid workers, in famine prone areas of the word, simply fluid is lost from the body and not fully replaced. Symptoms from forms of Dehydration include headaches, palpitations and in some cases confusion. Nutritional balances in the body can also be affected, so it is vital all symptoms are properly reported and treated.

So what are the causes of hyperemesis gravidarum ?  One in 50 pregnant women will experience Hyperemesis gravidarum It is more common in young mothers, also women in their first pregnancy, and those with multiple pregnancies ie twins or IVF.

The cause of hyperemesis gravidarum isn't fully known, although there are, as you might suspect, a number of theories, including changes in hormones, emotional changes occurring during pregnancy, nutritional deficiency, and gastrointestinal dysmotility where food binds or clumps in the digestive system, rather than moving smoothly through it. A full review of all medications taken over the previous year clearly needs to be undertaken.

Because the cause is not yet really understood, it's not possible to prevent hyperemesis gravidarum occurring. However, it is possible, and very important, to recognise it and treat it successfully.

So how can hyperemesis gravidarum be treated?  In the early stages, women with hyperemesis gravidarum may be advised to rest and possibly eat bite-size pieces of dry toast or dry crackers,  before getting out of bed, they should also have frequent but small meals. Fried or spicy foods, or even smells that trigger symptoms of nausea and vomiting, are best avoided. Some may benefit from eating ginger or foods prepared with ginger, such as ginger biscuits and crystallised ginger, or drinking ginger herbal tea.

A treatment which is often used to combat sea sickness:  Acupressure may help: Simply press a finger or thumb against the inside of the wrist or wear an elastic wristband with a plastic button or bead  sewn into it. Doctors may also recommend anti-nausea medication..  With severe symptoms, admission to hospital for a few days for observation and to treat dehydration with intravenous fluids may be the answer.  If the problem isn’t recognized and treated early there may be other issues such as premature labour and pre-eclampsia.

Although we have covered most of the symptoms and possible outcomes, it isn't possible to know all the circumstances of individual cases;  this can only be achieved  by medical consultation. But when the Prince hurries into his waiting car through a bombardment of flash bulbs you can understand why a jolly interview might not be forthcoming from the young concerned Royal.


Contributor: Julian Bray, Media Expert, Royal & Society Watcher Aviation, Politics & Travel Commentator, Broadcaster & Journalist Julian Bray NUJ, Equity Landline: 01733 345581 Mobile: 07944 217476 ISDN2  (UK HOME ISDN 01733 555319) G722/APT-X Dual Codecs SKYPE: JULIAN.BRAY.UK

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