Hyperemesis gravidarum, explained

The Duchess of Cambridge, Kate Middleton, is pregnant with her third child. Much like with her two other pregnancies, she’s once again being treated for a rare but serious condition called hyperemesis gravidarum (HG)—acute morning sickness.

According to the American Pregnancy Association, HG is characterized by "severe nausea, vomiting, weight loss and electrolyte disturbance" due to an increase in hormones.

"The inability to keep food down and get all the nutrition needed when a woman is pregnant needs to be watched very closely," explained Dr. Marcel Favetta, a Geisinger obstetrician-gynecologist. "It isn’t cause for panic, but it is cause for vigilance."

Mild HG cases are treated by changing the mother’s diet, getting extra rest and taking antacids. More severe cases may require IV fluids to hydrate the mother and restore electrolytes, vitamins and other nutrients. In some cases, the mother may be hospitalized for a few days. In 2012, when Kate was pregnant with her son George, she was hospitalized for several days. In 2014, when she was pregnant with Charlotte, she received treatment at Kensington Palace.

"The majority of women will not have a condition as rare and severe as Princess Kate’s, though 70 to 80 percent of women will experience the effects of morning sickness, particularly during their first trimester," said Dr. Favetta.

If you are pregnant and experiencing morning sickness, there are some things you can do at home to relieve and manage some of your symptoms.

Medications: Following your doctor’s advice, there are certain antihistamines, such as doxylamine, that may relieve your morning sickness

Ginger: After taking it for a few days, ginger may relieve your symptoms. It usually comes in the form of a powder in a capsule, but you can also add fresh ginger to hot water for tea.

Vitamin B6 and B12: Again, following the advice of your doctor, these supplements can help reduce your nausea and vomiting.

Acupressure: This helps relieve nausea for some women. You have a pressure point located at the middle of the inner wrist and three finger lengths away from the crease of the wrist, in between the two tendons. If you locate this point and press firmly, one wrist at a time for three minutes, you might start feeling better.

Pay attention to triggers: Avoid any smells and foods that make you feel nauseated. Citrus juice, milk, coffee and caffeinated tea make nausea worse for many pregnant women.

Choose food wisely: Try picking foods that are high in carbohydrates, low in fat and easy to digest. Salty foods are sometimes helpful, in addition to foods that contain ginger — such as ginger lollipops. Avoid greasy, spicy and fatty foods.

Snack often: Having an empty stomach can make your nausea worse. Eat several small meals every day instead of three large meals.

"For nausea in the morning, eat a small snack like crackers or dry toast before you get out of bed. Allow the snack to digest for a few minutes before slowly getting out of bed," said Dr. Favetta.

Drink plenty of fluids: Vomiting can dehydrate you, so it’s important to make sure you’re taking in enough fluids, including water, sports drinks, broth or juice.

Get rest: Try your best to get quality sleep – stress and fatigue can make nausea worse.

"Most women who suffer from morning sickness won’t need medical intervention to treat it," said Dr. Favetta. "But if you find that you can’t find relief from nausea and vomiting, you should talk to your doctor."

Dr. Marcel Favetta, MD, is a Geisinger obstetrician-gynecologist. Dr. Favetta sees patients at Geisinger’s East Mountain Specialty Clinic in Wilkes-Barre. To schedule an appointment with Dr. Favetta or another Geisinger OB-GYN specialist, please call 800-275-6401 or visit Geisinger.org.

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