Pregnancy Morning Sickness and Hyperemesis Gravidarum

Nausea and Vomiting is common symptom of pregnancy and commonly begins between 4th and 7th week of pregnancy and usually settles by 12-14 weeks, but in some women it may last longer. Though it is called morning sickness, it may occur at any time of day or night.
The cause of morning sickness is thought to be of pregnancy hormones called Human Chorionic Gonadotropin (HCG) and Pregnant women begin producing HCG shortly after fertilized egg attaches to the uterine lining, but it is unclear that why some women develop it so worse. Women are more likely to have it if 

  • a. She had it before
    b. She is having more than one baby
    c. She has molar pregnancy (a rare condition whereby placenta overgrows and baby does not form correctly

Pregnancy Morning sickness is sometimes common or it may be due to other causes which includes gastritis, kidney infection, appendicitis or gastroentitis. Hence it is important to consider morning sickness especially if vomiting is persistent and if person is constantly unwell, having pain in tummy or vomiting starts after 10 weeks of pregnancy

What is Hyperemesis Gravidarum

If nausea and vomiting become very severe that it leads to dehydration and significant weight loss, it is known as Hyperemesis Gravidarum. It may affect 1-3 in 100 pregnant women. Signs of dehydration includes feeling dry or very thirsty frequently, becoming drowsy or urine changing from a light yellow to dark yellow or brown color. Women with this condition may need to get admitted in a hospital and kept under medical supervision.

Nausea and vomiting of pregnancy can affect your mood, your home, your office and your responsibility towards others. In some women, this symptom can be so severe that they start feeling depressed and need extra support through proper counselling of their Mentors or Doctors.

There is no evidence that nausea and vomiting cause harm to baby but yes of course you still slightly have risk of miscarriage

Women with severe nausea and vomiting or with Hyperemesis Gravidarum may however have a baby with a lower-than-expected birthweight.

How to manage Morning Sickness

Women should

  1. Eat small amounts and frequent meal high in carbohydrates and proteins and low in fat such a potato, rice etc
  2. Just sip fluids between meals.
  3. Avoid any foods or smell that trigger these symptoms
  4. Avoid drinks that are too cold. Caffeine containing drinks like tea, coffee, soft drinks and energy drinks should be avoided.
  5. Iron supplements or pregnancy multivitamin may upset your stomach hence it becomes necessary to talk with Dietician before changing the supplement.
  6. Avoid Smoking, as this can make nausea worse and also harm your baby.
  7. Snack often in between time.

Some women find eating or drinking ginger products.

If your symptoms do not settle or if hinders your day-to-day activities, meet your Gynaecologist to discuss the issue who will prescribe morning sickness medicine which is safe to use.

Admission to the hospital may be advised by Gynaecologist if

  • a. Patient is dehydrated and having ketones in urine upon urine test
  • b. Have severe vomiting and unable to tolerate any fluids
  • c. Have significant weight loss
  • d. Have abnormal blood test
  • e. Have medical condition such as heart or kidney problem or diabetes

If patient is able to tolerate some fluids but are unable to drink enough, she will be offered fluids through drip in her arm over a short period of time. This is called Rapid Rehydration. She will be also given anti-sick medicine. If women feel better, then they are advised to go home.

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