Morning sickness, also known as ‘nausea and vomiting of pregnancy‘ (NVP), is a “normal” symptom of pregnancy that involves nausea or vomiting. It affects about 70–80% of all pregnant women to some extent at some stage. Despite its name, it is not just restricted to the mornings and can occur at any time of the day. Generally this is worse around 10 and 16 weeks of the pregnancy and most are gone around 20 weeks, however up to 10% still have symptoms after 22 weeks.
The cause is not clear, but possibly linked to changing levels of estrogen and the human chorionic gonadotropin hormones. Reduced blood glucose levels may play a role; so too might an increased sensitivity to some odors be involved. It has been suggested that morning sickness could be an evolved characteristic that protects the fetus against toxins that might be ingested by the mother.
The symptoms can be triggered by certain odors, spicy foods and heat. Not all get the vomiting and just have nausea.
Generally there are no consequences to the fetus of having morning sickness.
There is no known prevention except the avoidance of any triggers.
Treatment of Morning Sickness:
Dietary changes (bland diet; dry biscuits first thing in morning; smaller, more frequent meals; low doses of Vitamin B6 supplements; don’t skip meals; have someone else prepare the meals; drink 6-8 glasses of water a day)
Some find ginger helpful, but evidence limited.
Some report help from acupressure wristbands or acupuncture.
Many antiemetics are effective and safe in pregnancy (eg metaclopramide).
Thalidomide was originally prescribed as a miracle drug for morning sickness in the 60’s with disastrous consequences.
Hyperemesis gravidarum:
This is when the morning sickness so severe with the nausea and vomiting that it causes severe dehydration and loss of body weight. Occurs in 1-2% of pregnancies. Management is with hospital admission and IV liquids and nutrition.
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