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Sep 5

What is hyperemesis gravidarum? Pregnant Kate Middleton again suffering rare severe morning sickness condition –

The Duchess of Cambridge is expecting her third child - and is once again suffering from the severe morning sickness which blighted her previous pregnancies.

Kate was in the early stages of her pregnancy with Prince George when she was admitted to hospital in December 2012 with hyperemesis gravidarum, a rare condition which causes severe vomiting during pregnancy.

Awareness of her tendency to the condition meant her second pregnancy was announced relatively early, rather than waiting for the 12 week milestone, as she cancelled public duties due to sickness.

For women suffering hyperemesis gravidarum, the severity of the vomiting can cause dehydration, weight loss and a build-up of toxins in the blood or urine called ketosis.

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It affects 3.5 per 1,000 pregnant women and can cause women to vomit blood.

Symptoms also include severe nausea, low blood pressure and fast heart rate, headaches, lethargy or confusion.

It is treated by giving women fluids intravenously and by anti-sickness tablets.

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The cause of HG is unknown. The leading theories state that it is an adverse reaction to the hormonal changes of pregnancy.

It is more common in multiple pregnancies and is commonly experienced during the first 8 to 12 weeks of pregnancy.

A scientific study has given preliminary evidence there may be a genetic component.

Symptoms can be aggravated by hunger, fatigue, prenatal vitamins (especially those containing iron), odours, and diet.

"In very simple terms hyperemesis means vomiting a lot and gravidarum means in pregnancy," said consultant obstetrician Daghni Rajasingam, spokeswoman for the Royal College of Obstetricians and Gynaecologists in 2014.

"The diagnosis is given when women cannot keep food or fluid down because she has severe vomiting.

"The women who are vomiting pretty much constantly, that cannot keep any nutrients down, they need to be admitted to hospital."

She said the length of stay in hospital depends on each patient but many women are discharged in a matter of days.

"It depends on how well the woman is keeping fluids down," Ms Rajasingam added.

She said the condition is thought to be caused by elevated levels of the "pregnancy hormone" hCG.

The body begins to produce human chorionic gonadotrophin (hCG) after conception.

While cases of very severe, protracted and prolonged periods of vomiting are rare, nausea and vomiting in pregnancy is very common, affecting 60% to 80% of women.

About 5% of mothers-to-be will be admitted to hospital during their pregnancy with some degree of the condition, Ms Rajasingam said.

Once admitted, doctors will monitor women and let them go home once they can keep fluids down.

Some alternative therapies are used to help reduce the symptoms and duration of the nausea and vomiting, including acupuncture, travel sickness bands, eating ginger and other herbal remedies.

The condition is most common in the first 12 weeks of pregnancy, Ms Rajasingam added.

Caitlin Dean, trustee of the charity Pregnancy Sickness Support, also suffered from the condition.

"Imagine having a stomach bug that lasts for days and days, months and months - it is just relentless," she said.

"Any movement, any sound, any smell just makes you vomit.

"I vomited 20 to 30 times a day for the first few months, in the latter part it was just once or twice a day but it's still unpleasant.

"One of the big issues with it is isolation because is causes many women to be bed-bound.

"There is a real lack of understanding about the condition."

What is hyperemesis gravidarum? Pregnant Kate Middleton again suffering rare severe morning sickness condition -

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