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Princess Kate’s hospitalization for severe nausea and vomiting might be due to twins

Robin Wulffson MD's picture
Kate Middleton, hyperemesis gravidarum, nausea, vomiting, twins

Prince William’s wife, Catherine, the Duchess of Cambridge, has been admitted to the hospital with hyperemesis gravidarum. The condition might be due to twins. Most women experience nausea and vomiting in early pregnancy, a condition referred to as “morning sickness.” Hyperemesis gravidarum is a more serious form of the disease in which dehydration can occur; thus, as in Kate’s case, necessitating hospitalization.

The cause of nausea and vomiting during pregnancy is believed to be rapidly rising blood levels of a hormone called HCG (human chorionic gonadotropin), which is released by the placenta. However, other factors can play a role. The condition is more common in younger women with their first pregnancy. This is Kate’s first pregnancy and she is 30 years old. Stress and other lifestyle factors can play a role. In pregnancies with higher hormonal levels, hyperemesis gravidarum is more common. Multiple gestation (i.e., twins or triplets) is associated with an increased incidence of hyperemesis gravidarum. It can also occur in a molar pregnancy. This condition results from a pregnancy that degenerates very early into grape-like tissue and the absence of a fetus. Hopefully, this is not Kate’s problem. An ultrasound can diagnose multiple gestation or a molar pregnancy.

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Symptoms of hyperemesis gravidarum include severe, persistent nausea during pregnancy, often leading to weight loss. Lightheadedness or fainting can occur. Hospital treatment consists of intravenous fluids and anti-emetics (anti-nausea medication) that are deemed safe for pregnant women. Vitamin B6 (no more than 100 mg daily) has been reported to decrease nausea in early pregnancy. When the patient is able to resume oral intake, small, frequent meals and eating dry foods such as crackers may help keep the nausea under control. Women should drink plenty of fluids. The intake should bed increased during the times of the day when the nausea is at its lowest ebb. Seltzer or other sparkling waters may be helpful. The pregnant nose is more sensitive to odors. It is not uncommon for strong food odors to trigger a bout of nausea.

Fortunately, nausea and vomiting associated with pregnancy usually peaks between two and 12 weeks of gestation and goes away completely by the second half of pregnancy. Social or psychological problems may be associated with this disorder of pregnancy. If such problems exist, they need to be identified and addressed appropriately. With proper identification of symptoms and careful follow-up, hyperemesis gravidarum rarely presents serious complications for the infant or mother.

See also:
Should women take antidepressants during pregnancy?
Mercury exposure during pregnancy and ADHD risk in offspring