Local obstetrician and gynecologist Dr. Robert Wool explains the causes, symptoms and treatments of severe morning sickness that Kate Middleton, Duchess of Cambridge had.
Britain's Prince William stands next to his wife Kate, Duchess of Cambridge as she leaves the King Edward VII hospital in central London, Thursday, Dec. 6, 2012. Prince William and his wife Kate are expecting their first child, and the Duchess of Cambridge was admitted to hospital suffering from a severe form of morning sickness in the early stages of her pregnancy.
When the Duchess of Cambridge—the wife of Prince William—was hospitalized recently for severe morning sickness due to her pregnancy, the situation caught the world’s attention as most events related to the royal couple do.
While the former Kate Middleton was eventually released after receiving treatment for the severe vomiting, known in medical terms as hyperemesis gravidarum, her experience raised interest in the condition that is much worse than traditional morning sickness.
Dr. Robert Wool, an obstetrician and gynecologist at Women’s Health Associates in Springfield and Westfield, said the royal couple’s case brings attention to a medical topic that does not usually make headlines. Severe morning sickness, if treated in a timely manner, would not typically endanger mother or child, he said.
Wool recently offered some information about the condition, including symptoms, treatment options and frequency of the illness.
Q. Who is most likely to experience this illness?
A. Morning sickness happens in normal pregnancies. Over half of women will get some degree of nausea and vomiting early in pregnancy. Where it develops into a problem is when it becomes debilitating. When it gets to a point that you have to be hospitalized, then it’s a whole different thing. The problem is it’s a continuum from what’s normal to what women will tolerate.
Q. What are some of the warning signs or symptoms of severe morning sickness?
A. The warning signs and when you should treat is if you can’t keep nutrition in. If you have a little vomiting in the morning and then you can get a meal in later in the day, your blood sugar levels come up and you feel better, well then you’re probably fine. If you get to a point where you just can’t keep anything down for a couple of days and you get dehydrated and malnourished, this is all a continuum of the same spectrum of illness.
Q. What are some of the causes of morning sickness, severe or otherwise?
A. What makes women sick during pregnancy is generally thought to be high levels of the hormone estrogen produced. When there are higher levels of human chorionic gonadotropin (hCG) hormone produced some people don’t tolerate that very well. That’s when there may be a suspicion of twin pregnancy because women with twins produce more of the estrogen.
Q. What are treatment options?
A. When she gets to the hospital, the first thing they do is put an IV of 5 percent dextrose with lactated ringer’s solution. So it’s isotonic and has all the electrolytes and enough sugar to bring blood sugar levels up so they start feeling a little better. Once you start the IV fluids most of the time that’s all it takes.
And that’s what happened to Kate and that’s what happens to 95 percent of the people with hyperemesis gravidarum. They would also use medications to treat the nausea. The one that seem to work best these days is Zofran, pills that melt in a patient’s mouth. Sea sickness patches can also help.
Q. How common is this condition?
A. For the Kate Middleton’s out there, I would say 15-25 percent of women would need to come in for hydration. Remember, more than 50 percent of women experience nausea in the early stages of pregnancy.
Q. Is there any kind of particular strain on the mother or fetus during this illness?
A. The fetus is the best protected of the bunch. The mother will give up the nutrients to the fetus. She will get dehydrated so the fetus doesn’t. If it keeps up long enough there can certainly be a physiological strain on the pregnancy, but in the short-term, no. Sometimes there can be a strain on the family. They need to be supportive during times like this. The family needs to pitch in and realize that she’s not feeling great.