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    It Takes A Princess: Kate Middleton Pregnancy Draws Attention To Hyperemesis Gravidarum
    By News Staff | December 5th 2012 03:31 PM | 5 comments | Print | E-mail | Track Comments

    The announcement that Kate Middleton, Duchess of Cambridge (and, despite our title, not a princess, like Diana was, for arcane reasons that only experts in Teutonic monarchy understand) is expecting her first child is also bringing attention to a little-known pregnancy condition known as hyperemesis gravidarum (HG), a severe form of nausea and vomiting in pregnancy that can be debilitating because it causes serious dehydration and malnutrition. 

     Hyperemesis gravidarum is generally marked by unrelenting nausea and vomiting that prevents women from eating or drinking and unable to keep anything down for prolonged periods so it's more than morning sickness. Pregnant women who suffer from HG often lose weight during pregnancy and have difficulty carrying on daily activities and those with the most severe symptoms are often hospitalized or placed on intravenous feeding.

     Diagnosis is usually made by measuring weight loss, checking for ketones, and assessing the overall condition of the mother. Early intervention is important. Severe vomiting and nausea alone can cause complications including debilitating fatigue, gastric irritation, ketosis and malnutrition. Aggressive care early in pregnancy is very important to prevent these and more life-threatening complications. 


    Kate Middleton. Link: Sky Go

    It's estimated up to 2 percent of pregnant women in the U.S. are diagnosed with HG, and the advocacy group HER Foundation believes it is higher due to the visits they receive on their site. HG is not fully understood and a cause is not known but speculations abound and it may be a complex physiological disease caused by multiple factors.

    Recent estimations are that HG costs nearly $200 million annually just for inpatient hospitalization. Many women are treated outside the hospital to save costs, so the actual cost may be greater. 

    Dr. Marlena Fejzo, who has been conducting HG research at UCLA says, "I hope that Duchess Middleton is getting proper support and care including a thiamine shot if she is unable to tolerate vitamins to prevent a severe but completely avoidable HG-related condition, Wernicke's Encephalopathy. I also hope the suffering of Duchess Middleton leads to more awareness, funding, and participation in research for this devastating and misunderstood pregnancy disease so that scientists like myself, can find answers. My research focuses on identification of genes and risk factors for HG to identify the cause and cure and working with the HER Foundation." 


    Comments

    UvaE
    Diagnosis is usually made by measuring weight loss, checking for ketones, and assessing the overall condition of the mother.

    I wonder how hyperemesis gravidarum leads to abnormal carbohydrate metabolism. Ketone bodies including acetoacetic acid, acetone, and ß-hydroxybutyric acid which show up in the urine are normally only made by the liver.
    The morning sickness (hg) is causing starvation, obvious if the pregnant woman is losing weight. When the body goes into starvation mode, the first thing it does is start eating away at muscle as it has more energy in it. The acids are in the urine are proof that the muscles are breaking down, like a bi-product. This is what the Atkins diet counts on for weight loss. Eat no carbs, body breaks down existing muscle.

    I'm curious as to how many miscarriages this has caused. The old wives' tail on this side of the ocean is that the sicker a pregnant woman is in the very early days of the pregnancy, the more likely she will "lose" the baby. Then the doc states that the pregnancy ended in miscarriage (spontaneous abortion) because there was something wrong with the child / child to be depending up your belief system.

    UvaE
    This is what the Atkins diet counts on for weight loss. Eat no carbs, body breaks down existing muscle.
    Why would the body go into a protein-cannibalizing mode if the diet itself is high in protein? There have been some traditional cultures that have relied on low carbohydrate, high protein/fat diets: Eskimos, fishing communities etc.
    The title thing is pretty simple. Princess Diana wasn't Princess Diana. She was HRH The Princess of Wales during her marriage because she was married to HRH The Prince of Wales. The media called her Princess Diana but it wasn't her title. Kate is HRH the Duchess of Cambridge because she is married to HRH the Duke of Cambridge. Only daughters of the monarch (ie Princess Anne) and male-line granddaughters of a female monarch (ie Princess Beatrice) can be called Princess before their given name. After Diana's divorce, she was Diana, Princess of Wales, no HRH (this made her the only non-royal princess in British history). Of course if you wanted to properly refer to Kate as "Princess" it would be HRH Princess William of Wales, Duchess of Cambridge, etc. Female consort titles are derived entirely from the titles of the royal male she marries.

    Hank
    for arcane reasons that only experts in Teutonic monarchy understand
    Whew. Luckily one showed up!  :)  But "The title thing is pretty simple" took 150 words so it clearly isn't all that simple.