Vomiting During Pregnancy

Nausea and Vomiting During Early Pregnancy : Causes and treatments

Vomiting During Pregnancy is one of the most common symptoms in pregnancy. Also referred to as morning sickness. 70percent of pregnant women may experience morning sickness during the first trimester.

During pregnancy nausea may be a good sign, Research has shown that during the first trimester, women with nausea and vomiting have a lower chance than women with no such symptoms.

This generally occurs in the first trimester of pregnancy. Symptoms can begin at  6 weeks and may last for up to 14wks.

During pregnancy morning sickness is a frequent cause of vomiting. But nausea and vomiting can actually happen anytime during the day and at night, though it is called morning sickness.

Morning sickness can affect you any time of day and night or some women may feel sick the whole day this doesn’t have any risk to the baby these may disappear at 16 to 20 wks of pregnancy. Women typically feel sick for a brief period of time every day and will vomit once or twice a day.

Some pregnant women have excessive nausea and vomiting. This condition is referred to as hyperemesis gravidarum and sometimes requires hospital management.

Research has shown that the effects of human chorionic gonadotropin ( HCG) can result in nausea and vomiting during pregnancy.

Pregnant women start producing HCG soon after a uterine lining has been attached to a fertilized egg. Higher HCG levels are found in women with extreme morning illness (hyperemesis gravidarum) than in other women who are pregnant.

Moreover, women who are pregnant with twins or triplet pregnancies are more likely to have morning sickness also experience higher levels of HCG.

Oestrogen is also associated with an increase in the severity of nausea and vomiting during pregnancy,

Causes Of Vomiting In Pregnancy

  • Hormone variations can be one contributing factor during pregnancy. Hormones that can trigger heartburns, indigestion, and acid reflux, all of which are considered possible signs of pregnancy and potential vomiting triggers during pregnancy,
  • While it is not completely known what causes morning sickness, certain risk factors raise a person’s probability of more serious symptoms:
  • Multiple pregnancies, i.e. twin or triplet pregnancy.
  • Had an earlier  pregnancy with nausea and vomiting pregnancy
  • Family history of serious maternal nausea and vomiting
  • Migraine history
  • Nausea and vomiting during pregnancy may be associated with other medical conditions such as thyroid disease, food poisoning, ulcer, gall bladder disease.
  • The immune system becomes weak during pregnancy, hence they are at higher risk for food poisoning than others.

How to control over vomiting during pregnancy

Pregnant women may take measures to reduce the risk of vomiting — mainly in terms of diet, or lifestyle. These comprise:

  • Eat small meals or snacks at a frequent interval of two to three hours than three large meals  a day
  • Avoid foods with strong odours that cause nausea
  • Avoid fried spicy or greasy foods.
  • Avoid drinking lots of fluid at a time instead drink clear fruit juices water ice chips throughout the day.
  • Try to eat high protein snacks before bedtime.
  • Eat dry foods such as toast crackers cereals before getting out of bed.
  • Taking  prenatal vitamins
  • Ginger intake or supplements

In order to minimize their risk of food poisoning, pregnant women must  avoid certain food products, such as;

  • unwashed fruits and vegetables
  • raw or undercooked eggs
  • unpasteurized milk
  • unpasteurized cheese
  • raw fish

Treatment

Treatment depends on the severity however medical management includes

Doxylamine and B-6; They are safe to take individually or combine during pregnancy because they do not affect the fetus.

Antiemetic medicines; the doctor can prescribe such medicines to prevent vomiting if the above combination doesn’t work.

Hyperemesis Graviderum

Hyperemesis graviderum

Hyperemesis gravidarum is a rare condition that is much more serious than morning sickness associated with intense nausea and vomiting during pregnancy leading to dehydration.

The women with morning sickness may get relief at the end of 14wks but hyperemesis graviderum may experience their morning sickness after 14 weeks and last through the rest of a pregnancy.

Causes of hyperemesis graviderum

  • The high rise of serum human chorionic gonadotrophin level, Estrogen, and Progesterone level
  • Multiple pregnancies (Twin or Triplet pregnancy)
  • Hydatiform mole or Vesicular mole
  • Family history of hyperemesis graviderum
  • Overweight patients.

Symptoms of Hyperemesis graviderum

  • Vomiting more than three to four times a day
  • The feeling of faintness or lightheaded
  •  Complete Loss of appetite
  • Loses weight more than 10 pounds
  •  Persistent vomiting leading to Dehydration
  • Decrease in urination
  • Headache
  • Confusion

How to diagnose hyperemesis graviderum

  • Physical examination of patients enough to diagnose most cases usually physician will look for common signs of hyperemesis such as low blood pressure and fast pulse.
  • It is necessary to take a blood and urine sample to rule out signs of dehydration. The blood test may include routine tests with serum electrolytes and thyroid profile levels.
  • The doctor may also suggest doing some additional tests to find out gastrointestinal problems which may be the cause of nausea and vomiting.
  • Ultrasound to rule out multiple pregnancies or hydatiform (vesicular )mole.

Management of hyperemesis graviderum

Do not try to take any medication without consulting your doctor.

Mild cases can be treated with rest, some alterations in diet and antacids.

More severe cases need to be hospitalized so that the mother can receive nutrition and fluids through an intravenous line. mother dehydration is a more serious issue in extreme cases of hyperemesis graviderum.

Pregnant women unable to sustain fluids or food because of persistent nausea or vomiting must receive fluids intravenously or by IV.

Hospital management;

Intravenous fluid;

  • To treat electrolyte imbalance
  • To restore hydration and
  • To restore vitamins and nutritional deficiency.

Other treatments may include:

Bed rest; It may help to get comfort, however, too much bed rest may result in weight loss and muscle loss.

Herbs – ginger or peppermint may help to reduce nausea and vomiting.

The good news is that after birth, HG symptoms vanish. Postpartum recovery for women with HG can, however, take longer.

Difference Between Morning sickness and Hyperemesis graviderum

Morning sickness and HG are symptoms that are very distinct. For every pregnant woman, they have various complications and side effects. To treat the symptoms correctly, it is necessary to differentiate between these two conditions.

Morning sickness 

  • Morning sickness is associated with nausea sometimes accompanied by vomiting.
  • Vomiting does not lead to dehydration
  • Symptoms  usually subside at 12 to 14 wks
  • Vomiting may cause loss of appetite
  • Feeling fatigued and feels difficulty in performing daily activities.
  • Vomiting allows us to keep some food down.
  • Can be treated by medications

Hyperemesis gravidarum

  • Hyperemesis graviderum in this condition nausea associated with severe vomiting
  • Persistent nausea does not subside.
  • Vomiting results in dehydration
  • Symptoms begin at 6 wks of pregnancy.
  • It is highly debilitating results in fatigue which may last for weeks or months.
  • Complete loss of appetite not able to perform daily activities.
  • Dehydration may lead to poor weight gain during pregnancy.
  • Hyperemesis graviderum needs hospitalization to treat.
  • This condition does not allow to keep any fluids or food down.

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