London - The Duchess of Cambridge is suffering from the same form of extreme morning sickness that affected her first pregnancy.
She is being treated at home at Kensington Palace but her symptoms are said to be just as severe as when she was expecting Prince George nearly two years ago.
In December 2012, she spent three days at the King Edward VII private hospital in Central London, where she was put on a drip after becoming very dehydrated.
Such extreme morning sickness, or hyperemesis gravidarum, is thought to affect up to one in 50 expectant mothers.
Symptoms typically begin about eight weeks after conception. Unfortunately for those affected, a woman who has it during her first pregnancy has a four in five chance of suffering it the next time – and it usually gets progressively worse with each child. It is far more severe than ordinary morning sickness.
Some women vomit 20 or 30 times a day and are bedbound. They may lose between five and 10 percent of their bodyweight when they are supposed to be gaining about 1lb (450g) a week. In a fifth of sufferers, the sickness continues right up to the birth, although for Kate last time it lasted until 12 weeks into her pregnancy.
The condition can affect the baby’s development and there is a risk it will be premature or have a very low birth weight. In severe cases, the sickness can trigger a miscarriage.
But it did not seem to be a problem for Prince George – he was born a healthy 8lb 6oz (about 3.8kg), the heaviest future king in 100 years – and was several days overdue.
Scientists do not know what causes extreme morning sickness, although it seems to run in families. One theory is that it is a severe reaction to a hormone, beta human chorionic gonadotropin, released during early pregnancy. This would explain why symptoms are worse in the first three months, when levels of the hormone are at their highest.
There are several preventative steps that can reduce the effects. Some women take vitamin B6 – which prevents sickness – as soon as they know they are pregnant. Others may take stronger anti-nausea tablets such as cyclizine, which is also used to treat travel sickness and is said to be very effective.
Sufferers are advised to take plenty of fluids and try to have small snacks throughout the day as an empty stomach can trigger nausea. If they cannot keep food down they will need anti-sickness medication and to be put on a drip.
Caitlin Dean, 33, founded the charity Pregnancy Sickness Support having suffered from the condition with each of her three children. Although she needed hospital treatment each time, symptoms were worst with her second child.
For her third, she was more mentally prepared. She said: “It’s not uncommon to hear it gets worse with each pregnancy – most at least have it to the same severity.
“But with careful pre-emptive planning you can reduce the symptoms. In advance you can take vitamin B6, which offers a protective effect, and there are some newer treatments. You are largely bedbound and smells – even lemon or the smells of your first child – can trigger retching. Your sense of smell is heightened in pregnancy but with this it becomes warped.
“Sounds – a noisy toddler – can trigger it. It’s a real challenge for second pregnancies. She [Kate] has a nanny to her advantage.”
Consultant obstetrician Daghni Rajasingam, of the Royal College of Obstetricians and Gynaecologists, said: “Women need to ensure they keep well hydrated with water and try to eat small and frequent meals.
“They should rest as much as they can. If they cannot keep food down then they should seek advice from a GP. Babies generally do very well, although it’s not at all pleasant for the mothers.” - Daily Mail