Kate's Royal Pain: Hyperemesis Gravidarum

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It's the news we've been waiting for—the next royal is on the way! But when St. James' Palace announced on Monday that Prince William and Duchess Catherine are pregnant with their first child, the joyous news was accompanied by a not-so wonderful side item: Middleton is in the hospital right now being treated for hyperemesis gravidarum, an extreme form of morning sickness that, left untreated, can lead to dehydration and excessive weight loss.

Never heard of it? While up to 90 of pregnant women experience some degree of nausea and vomiting during early pregnancy, approximately 2 percent of women experience the more severe symptoms of hyperemesis gravidarum, or HG, explains pediatrician and parenting author, Dr. David L. Hill. The condition appears to be related to the rapid rise of HCG (human chorionic gonadotropin) that occurs in the first trimester of pregnancy, and some moms-to-be appear more likely than others to develop HG. "Younger women and those experiencing their first pregnancies are at greater risk, as are women carrying girls or twins," Hill tells BabyZone. In other words, get ready for the onslaught of 'Will and Kate are having twin girls' rumors!

How do you whether it's morning sickness or hyperemesis gravidarum that's got you turning green? According to the Hyperemesis Education and Research (HER) Foundation, key differences between the two include:

Morning Sickness

• You lose little, if any, weight.
• Nausea and vomiting do not interfere with your ability to eat or drink enough each day.
• Vomiting and nausea may cause discomfort and misery, but are not severe.
• Dietary and/or lifestyle changes are enough to help you feel better most of the time.
• Symptoms improve gradually after the first trimester, though you may still feel a little queasy at times during the remainder of your pregnancy.
• You will be able to work most days and care for your family.

Hyperemesis Gravidarum

• You lose 5-20 pounds (more than 5% of your pre-pregnancy weight)
• Nausea and vomiting cause you to eat very little and get dehydrated
• You vomit often and may vomit bile or blood. Nausea is usually moderate to severe and constant.
• You require IV fluid hydration and/or medications to stop the vomiting.
• You feel somewhat better by mid-pregnancy, but may continue to be nauseous and/or vomit until late pregnancy.
• You are unable to work for weeks or months—and you might need help caring for yourself.

Of course, your doctor or midwife is the best person to help you understand whether it's run of the mill morning sickness—or something more serious.

And if it is HG? Mild forms of hyperemesis gravidarum are treated much the same as morning sickness. As Hill explains, "Treatment starts with dietary interventions: women should have small, frequent snacks and eat as soon as they feel hungry. Foods like crackers or cereal often go down well."Some moms may identify dietary triggers for their nausea which, naturally, they should avoid. "Cold, clear, carbonated, and sour fluids stay down better, and drinking with a straw may help as well," he adds. "Drinking small, frequent sips works better than gulping. Peppermint, ginger, accupressure, and hypnosis may all help symptoms as well."

Being admitted to the hospital to receive IV fluids and nutritional supplements, as is the case with Duchess Catherine, implies a more severe form of HG. "In severe cases, usually where the mother is experiencing substantial weight loss or dehydration, hospitalization may be the only alternative. There the mom can receive IV fluids and careful dietary and medical management to protect her and the pregnancy," according to Hill.

Anti-vomiting medications may also be prescribed, but only with caution. "For more severe cases there are a variety of medications that doctors can prescribe, but since not all medicines are safe in pregnancy it's important to work with an obstetrician rather than trying medicines over the counter," advises Hill.

As for the Duchess, all we can is, poor Kate. Reports say that she's barely 12 weeks along, and one has to wonder if she would have kept her pregnancy under wraps a little longer had she not required hospitalization.

However, maybe she's shopping online for lots of fabulous maternity clothes while she's laid up? Or putting together the perfect baby gift registry for a future heir to throne? However she's whiling away her time while she's on the mend, we only have one thing to say:

This too shall pass.