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The Portland hospital

Congratulations to The Duke and Duchess of Cambridge

05 December 2012

The Portland Hospital for Women & Children joins the millions of people around the world congratulating The Duke and Duchess of Cambridge on the happy news that they are expecting their first child together.

At The Portland we always enjoy seeing the excitement that the news of a pregnancy can bring to a couple and their families. We also understand the apprehension that pregnancy can bring and sometimes, like in the case of The Duchess, issues including severe morning sickness or Hyperemesis Gravidarum (HG).

But what is HG? Is there a difference between general morning sickness and the more acute versions and is this something that you should be concerned about? To give us an overview and answer these questions, we have asked Consultant Obstetrician and Gynaecologist at The Portland, Professor Ellis Downes, to give us some advice:

What is Hyperemesis Gravidarum?

HG is an unusual condition believed to affect up to five per cent of pregnant women and tends to be more common in women in their first pregnancy or those with multiple pregnancies - twins. The condition differs to general morning sickness experienced by the majority of pregnant women as it results in the severe sickness and nausea making it difficult to eat and drink normally.

Women with the condition may experience weight loss - up to 10% of their body mass, and they may feel exhausted, dizzy and dehydrated. In addition, HG can rarely lead to the risk of nutritional deficiencies, which if not treated, could affect the unborn baby. However with prompt treatment there is no risk to the unborn baby and women usually recover very quickly.

What is the prognosis?

For the vast majority of women, the symptoms of excessive sickness and vomiting settle in the first 14 weeks. In the vast majority of cases, sickness is a sign that the pregnancy is healthy because of a good level of pregnancy hormones. There is a rapid rise of pregnancy hormones (beta HCG used in pregnancy tests) in the first 13 weeks of pregnancy which is when the symptoms can be at their most severe. In HG, the high levels of pregnancy hormones cross into the brain where they can cause the vomiting centre of the brain to become active. It’s still not fully understood why some women are affected more than others.

In HG, cases where symptoms are severe, women may need to be admitted to hospital for a few days to ensure that they are observed and treated for dehydration with intravenous fluids. After which they are discharged and asked to keep check of their symptoms and continue to look forward to what will be one of the highlights of their life.

If you think that you may be experiencing HG, then you should seek help from your midwife or consultant immediately.

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