With news that Catherine, the Duchess of Cambridge, is hospitalized (again) with severe morning sickness, there are countless mothers rolling their eyes, and many mothers-to-be dreading the possibility of feeling that bad.

Almost any woman who has been pregnant can tell you the moniker “morning sickness,” is a bit of a misnomer since the nausea can strike at any time.  While most women experience some form of morning sickness, most manage the nausea and vomiting on their own. However, there are women who do suffer from extreme morning sickness.

Extreme morning sickness is known in the medical community as hyperemesis gravidarum, and effects approximately 1% of pregnant women.  It tends to start earlier in pregnancy than regular morning sickness, and last longer. Typical morning sickness tends to wane as the second trimester begins, however for those with hyperemesis gravidarum the nausea and vomiting can last longer, even through the entire pregnancy.

While the nausea and vomiting associated with normal morning sickness is not considered harmful to mother or baby, hyperemesis gravidarum can potentially be harmful to the health of mother, baby, or both.  While many women who experience some vomiting in the first trimester may notice slight weight loss, women with severe morning sickness cannot keep enough in their stomach to meet the nutritional needs of mother and baby.

Also, persistent vomiting can lead to dehydration, which under normal circumstances is dangerous, but when pregnant can endanger the fetus.  A women with hyperemesis gravidarum who does not get treatment is at risk for complications, including organ failure and premature birth.

Currently, the causes of morning sickness, let alone severe morning sickness, are unknown. Some research has shown that it could be related to the levels of a hormone called human chorionic gonadotropin, or HCG. While every woman and every pregnancy are different there are some factors that might make you more prone to experiencing hyperemesis gravidarum.

If your mother or grandmother experienced severe morning sickness, you might be more prone to it. Also, those who are have a history of motion sickness, or migraines with vomiting or nausea, and those who are carrying multiples are at higher risk for developing such severe symptoms.

Signs of hyperemesis gravidarum include persistent nausea, inability to eat or keep anything down, weightloss, faintness or dizziness, rapid heartbeat, recurrent headaches, extreme fatigue, and confusion. While some of these symptoms are par for the course with pregnancy, if you are suffering from morning sickness, talk to your doctor.

For many women, there is little that can be done. For severe nausea, some doctors prescribed Zofran, and anti-nausea drug that is commonly used to treat nausea in cancer patients undergoing chemotherapy. 

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