What are the common causes of nausea and vomiting during pregnancy. How can pregnant women manage morning sickness symptoms. When should expectant mothers seek medical attention for severe nausea and vomiting.

Understanding Morning Sickness: More Than Just a Morning Affair

Nausea and vomiting of pregnancy (NVP), commonly known as morning sickness, is a prevalent condition that affects many expectant mothers. Despite its name, this condition can occur at any time of the day or night. While it typically doesn’t pose a threat to the fetus, it can significantly impact a woman’s daily life and ability to carry out routine activities.

When does morning sickness typically begin and end? For most women, NVP starts before the 9th week of pregnancy and subsides by the 14th week. However, some women may experience these symptoms for several weeks or months, with a small percentage enduring them throughout the entire pregnancy.

Severity of Morning Sickness

The intensity of NVP can vary greatly among pregnant women. Some may experience mild nausea for a short duration each day, accompanied by occasional vomiting. In more severe cases, nausea can persist for several hours daily, with frequent episodes of vomiting. If you find that NVP is significantly affecting your quality of life, it’s crucial to consult your obstetrician-gynecologist (ob-gyn) or obstetric care provider.

Hyperemesis Gravidarum: When Morning Sickness Becomes Severe

Hyperemesis gravidarum represents the most severe form of NVP, affecting up to 3% of pregnancies. This condition is typically diagnosed when a woman has lost 5% of her pre-pregnancy weight and experiences complications related to dehydration.

• Requires medical treatment, sometimes hospitalization
• Aims to stop vomiting and restore body fluids
• Can lead to more serious health complications if left untreated

Recognizing Dehydration: A Serious Complication

One of the primary concerns with severe nausea and vomiting is the risk of dehydration. How can you identify signs of dehydration during pregnancy? Be alert for the following symptoms:

• Dark-colored urine in small amounts
• Inability to urinate
• Difficulty keeping liquids down
• Dizziness or fainting when standing up
• Racing or pounding heartbeat

If you experience any of these symptoms, it’s crucial to contact your healthcare provider immediately.

Risk Factors for Severe Nausea and Vomiting in Pregnancy

While NVP can affect any pregnant woman, certain factors may increase the likelihood of experiencing severe symptoms. What puts some women at higher risk for intense morning sickness?

1. Multiple pregnancy (carrying more than one fetus)
2. Previous pregnancy with mild or severe NVP
3. Family history of severe NVP (mother or sister)
4. History of motion sickness or migraines
5. Carrying a female fetus

Understanding these risk factors can help expectant mothers and their healthcare providers prepare for potential complications and implement preventive measures when possible.

Medical Conditions That Can Mimic or Exacerbate Morning Sickness

While NVP is common, it’s important to be aware that certain medical conditions can cause similar symptoms during pregnancy. These conditions may require different treatment approaches and should be ruled out by a healthcare professional.

Red Flags: When to Suspect Other Medical Conditions

Your ob-gyn or obstetric care provider might suspect an underlying medical condition if you experience symptoms that are atypical for regular NVP. What are some signs that warrant further investigation?

• Nausea and vomiting that begin after 9 weeks of pregnancy
• Abdominal pain or tenderness
• Fever
• Headache
• Enlarged thyroid gland (swelling in the front of the neck)

If you experience any of these symptoms, it’s essential to consult your healthcare provider for a thorough evaluation.

The Impact of Nausea and Vomiting on Maternal and Fetal Health

In most cases, NVP does not pose a significant risk to the health of the mother or the fetus. However, severe and prolonged cases can lead to complications if left unmanaged. How can extreme nausea and vomiting affect pregnancy outcomes?

• Maternal weight loss
• Potential impact on fetal birth weight
• Thyroid and liver function issues
• Fluid balance disruptions

Given these potential risks, healthcare providers often recommend early intervention and management strategies for women experiencing severe NVP or hyperemesis gravidarum.

Management Strategies for Nausea and Vomiting in Pregnancy

While NVP can be challenging to manage, there are various strategies that can help alleviate symptoms and improve quality of life for expectant mothers. What are some effective ways to cope with morning sickness?

Dietary Modifications

• Eat small, frequent meals throughout the day
• Choose bland, easily digestible foods
• Stay hydrated with clear fluids
• Avoid strong smells and triggers

Lifestyle Adjustments

• Get plenty of rest
• Practice stress-reduction techniques
• Wear acupressure wristbands
• Try ginger in various forms (tea, capsules, candies)

Medical Interventions

In cases where lifestyle and dietary changes are insufficient, healthcare providers may recommend medical interventions. These can include:

• Vitamin B6 supplements
• Antiemetic medications (after careful consideration of risks and benefits)
• Intravenous fluids for severe dehydration

It’s crucial to consult with your healthcare provider before starting any new treatments or medications during pregnancy.

The Psychological Impact of Severe Nausea and Vomiting in Pregnancy

The experience of severe NVP or hyperemesis gravidarum can have significant psychological effects on expectant mothers. How does prolonged morning sickness affect mental health during pregnancy?

• Increased stress and anxiety
• Feelings of isolation and frustration
• Potential for depression
• Impact on relationships and social interactions

Recognizing the emotional toll of severe NVP is crucial for providing comprehensive care to affected women. Healthcare providers should address both the physical and psychological aspects of the condition.

Support Systems and Coping Strategies

Developing a strong support system can make a significant difference for women struggling with severe NVP. What resources can help pregnant women cope with persistent nausea and vomiting?

• Support groups (online or in-person)
• Counseling or therapy
• Open communication with partners and family members
• Education about the condition for loved ones

By addressing the emotional aspects of NVP, healthcare providers can help ensure a more positive pregnancy experience for affected women.

Research and Future Directions in Managing Nausea and Vomiting of Pregnancy

As our understanding of NVP continues to evolve, researchers are exploring new avenues for prevention and treatment. What are some promising areas of research in the field of morning sickness management?

• Genetic factors influencing NVP susceptibility
• Novel antiemetic medications with improved safety profiles
• Non-pharmacological interventions (e.g., acupuncture, hypnosis)
• Predictive models for identifying high-risk women

Ongoing research in these areas holds the potential to significantly improve the care and quality of life for women experiencing NVP and hyperemesis gravidarum.

The Role of Personalized Medicine

As we move towards more individualized healthcare approaches, how might personalized medicine impact the management of NVP? Future treatments may be tailored based on:

• Genetic predisposition
• Individual risk factors
• Specific symptom patterns
• Response to previous interventions

This personalized approach could lead to more effective and targeted treatments for women suffering from severe NVP.

The Importance of Comprehensive Prenatal Care in Managing NVP

Effective management of nausea and vomiting in pregnancy requires a holistic approach to prenatal care. How can healthcare providers ensure comprehensive care for women experiencing NVP?

• Regular monitoring of symptoms and severity
• Timely intervention for worsening conditions
• Integration of nutritional counseling
• Addressing psychological well-being
• Involving partners and family members in the care plan

By adopting a comprehensive care model, healthcare providers can better support women through the challenges of NVP and promote healthier pregnancy outcomes.

The Role of Patient Education

Empowering pregnant women with knowledge about NVP is crucial for effective management. What key information should be provided to expectant mothers?

• Normal range of symptoms and when to seek help
• Self-care strategies and lifestyle modifications
• Available treatment options and their safety profiles
• Potential complications and warning signs
• Resources for emotional support and coping strategies

By ensuring that women are well-informed about NVP, healthcare providers can promote better self-management and timely intervention when needed.

Navigating Work and Social Life with Severe NVP

For many women, severe nausea and vomiting can significantly impact their ability to work and maintain social relationships. How can expectant mothers balance their professional and personal lives while managing NVP?

Workplace Accommodations

• Flexible work hours or remote work options
• Access to a quiet rest area
• Modifications to job duties if necessary
• Open communication with employers about the condition

Maintaining Social Connections

• Educating friends and family about NVP
• Exploring alternative ways to socialize (e.g., short visits, virtual connections)
• Being honest about limitations and needs
• Seeking support from others who have experienced NVP

By implementing these strategies, women with severe NVP can better navigate the challenges of maintaining their professional and social lives during pregnancy.

Long-Term Implications of Severe NVP and Hyperemesis Gravidarum

While most cases of NVP resolve by the second trimester, severe cases and hyperemesis gravidarum can have lasting effects. What are some potential long-term implications for women who experience these conditions?

• Increased risk of postpartum depression
• Potential impact on future pregnancy planning
• Lingering nutritional deficiencies
• Psychological effects on bonding with the baby

Understanding these potential long-term effects is crucial for providing appropriate follow-up care and support to women who have experienced severe NVP or hyperemesis gravidarum.

Post-Pregnancy Care and Support

How can healthcare providers ensure adequate support for women after a pregnancy complicated by severe NVP? Consider the following approaches:

• Regular postpartum check-ups to assess physical and emotional well-being
• Nutritional counseling to address any deficiencies
• Psychological support or referral to mental health professionals if needed
• Education about potential risks in future pregnancies
• Connecting women with support groups or peer counseling programs

By providing comprehensive post-pregnancy care, healthcare providers can help women recover fully from the experience of severe NVP and prepare for future pregnancies if desired.

Morning Sickness: Nausea and Vomiting of Pregnancy

• 
  
  

  Nausea and vomiting of pregnancy is a common condition. It can occur any time during the day, even though it’s often called “morning sickness.” Nausea and vomiting of pregnancy usually doesn’t harm the fetus, but it can affect your life, including your ability to work or go about your normal everyday activities. There are safe treatment options that can make you feel better and keep your symptoms from getting worse.

• 
  
  

  Nausea and vomiting of pregnancy usually starts before 9 weeks of pregnancy. For most women, it goes away by 14 weeks of pregnancy. For some women, it lasts for several weeks or months. For a few women, it lasts throughout the pregnancy.

• 
  
  

  Some women feel nauseated for a short time each day and might vomit once or twice. In more severe cases, nausea lasts several hours each day and vomiting occurs more frequently.

• 
  
  

  You should talk with your obstetrician-gynecologist (ob-gyn) or other obstetric care provider if nausea and vomiting of pregnancy affects your life and causes you concern.

• 
  
  

  Hyperemesis gravidarum is the term for the most severe form of nausea and vomiting of pregnancy. Hyperemesis gravidarum occurs in up to 3 percent of pregnancies.

• 
  
  

  This condition may be diagnosed when a woman has lost 5 percent of her prepregnancy weight and has other problems related to dehydration, or loss of body fluids (see below). Women with hyperemesis gravidarum need treatment, sometimes in a hospital, to stop the vomiting and restore body fluids.

• 
  
  

  Nausea and vomiting can cause you to lose fluids. If fluids are not replaced, it can lead to dehydration. You should call your ob-gyn or other obstetric care provider if you have the following signs and symptoms of dehydration:

  • You have a small amount of urine that is dark in color.

  • You are unable to urinate.

  • You cannot keep down liquids.

  • You are dizzy or faint when standing up.

  • You have a racing or pounding heartbeat.

• 
  
  

  Any of the following can increase the risk of severe nausea and vomiting of pregnancy:

  • Being pregnant with more than one fetus (multiple pregnancy)

  • A previous pregnancy with either mild or severe nausea and vomiting

  • Your mother or sister had severe nausea and vomiting of pregnancy

  • A history of motion sickness or migraines

  • Being pregnant with a female fetus

• 
  
  

  Yes, some medical conditions can cause nausea and vomiting during pregnancy. These conditions include:

  Your ob-gyn or other obstetric care provider might suspect that you have one of these conditions if you have signs or symptoms that usually do not occur with nausea and vomiting of pregnancy. Some of these signs and symptoms include:

  • Nausea and vomiting that occurs for the first time after 9 weeks of pregnancy

  • Abdominal pain or tenderness

  • Fever

  • Headache

  • Enlarged thyroid gland (swelling in the front of the neck)

• 
  
  

  This condition usually does not harm your health or your fetus’s health. It also does not mean that your fetus is sick.

• 
  
  

  Nausea and vomiting can become more of a problem if you cannot keep down food or fluids and begin to lose weight. When this happens, it sometimes can affect the fetus’s weight at birth.

• 
  
  

  Weight loss can lead to problems with your thyroid, liver, and fluid balance. Because hyperemesis gravidarum is difficult to treat and can cause health problems, experts recommend early treatment so that it does not become severe.

• 
  
  

  Changes to your diet and lifestyle might help you feel better. These change can include:

• 
  
  

  Yes, take a prenatal vitamin. Studies show that taking a vitamin supplement before and during pregnancy reduces the risk of having severe nausea and vomiting of pregnancy.

• 
  
  

  • Eat dry toast or crackers in the morning before you get out of bed to avoid moving around on an empty stomach.

  • Eat five or six “mini meals” a day to ensure that your stomach is never empty.

  • Eat frequent bites of foods like nuts, fruits, or crackers.

• 
  
  

  Try bland foods. The BRATT diet (bananas, rice, applesauce, toast, and tea) is low in fat and easy to digest. If these foods don’t appeal to you, try others. The goal is to find foods that you can eat and that stay down.

• 
  
  

  Yes, try adding protein to each meal. Good nonmeat sources of protein include:

  • Dairy foods, such as milk, ice cream, and yogurt

  • Nuts and seeds, including butters like almond butter and peanut butter

  • Protein powders and shakes

• 
  
  

  Ginger can help settle your stomach. You can try:

• 
  
  

  Yes, your body needs more water during pregnancy. Drink throughout the day, not just when you are thirsty. Aim for 8 to 12 cups of water a day during pregnancy.

  Not drinking fluids can lead to dehydration, which can make nausea worse. If a bad taste in your mouth makes it hard to drink water, chew gum or eat hard candy.

• 
  
  

  Foods or odors that might never have bothered you before might now trigger nausea. Do your best to stay away from them. Use a fan when cooking. Have someone else empty the trash.

• 
  
  

  Frequent vomiting can cause some of your tooth enamel to wear away, due to the acid in your stomach. Rinse your mouth with a teaspoon of baking soda dissolved in a cup of water to help neutralize the acid and protect your teeth.

• 
  
  

  If diet and lifestyle changes don’t help, or if you have severe nausea and vomiting of pregnancy, you might need medical treatment. Your ob-gyn or other obstetric care provider will first want to know whether your symptoms are due to nausea and vomiting of pregnancy or another medical cause. If other causes are ruled out, you may be able to take certain medications:

  • Vitamin B6 is a safe, over-the-counter treatment that may be tried first for nausea and vomiting of pregnancy.

  • Doxylamine, a medication found in over-the-counter sleep aids, can be added if vitamin B6 alone does not relieve symptoms.

  • A prescription drug that combines vitamin B6 and doxylamine is available. Both drugs, taken alone or together, have been found to be safe to take during pregnancy and have no harmful effects on the fetus.

• 
  
  

  “Antiemetic” drugs, which prevent vomiting, may be prescribed for women who aren’t helped by other medications.

• 
  
  

  Many antiemetic drugs have been shown to be safe to use during pregnancy. But others have conflicting or limited safety information. For example, a drug called ondansetron is highly effective in preventing nausea and vomiting, but studies are not clear about its safety for the fetus. Ondansetron also has been linked to heart-rhythm problems in people taking the drug, especially in those who have certain underlying conditions.

• 
  
  

  The decision to use ondansetron and other drugs during pregnancy is based on whether the benefits of these drugs outweigh their potential risks. You and your ob-gyn or other obstetric care provider can discuss all of these factors to determine the best treatment for you.

• 
  
  

  If your nausea and vomiting are severe or if you have hyperemesis gravidarum, you might need to stay in the hospital until your symptoms are under control.

• 
  
  

  • Lab tests may be done to check how your liver is working.

  • If you are dehydrated, you may receive fluids and vitamins through an intravenous (IV) line.

  • If your vomiting cannot be controlled, you might need additional medication.

  • If you continue to lose weight, a feeding tube may be recommended to ensure that you and your fetus are getting enough nutrients.

• 
  
  

  Dehydration: A condition that happens when the body does not have as much water as it needs.

  Fetus: The stage of human development beyond 8 completed weeks after fertilization.

  Hyperemesis Gravidarum: Severe nausea and vomiting during pregnancy that can lead to loss of weight and body fluids.

  Intravenous (IV) Line: A tube inserted into a vein and used to deliver medication or fluids.

  Multiple Pregnancy: A pregnancy where there are 2 or more fetuses.

  Nausea and Vomiting of Pregnancy: A condition that occurs in early pregnancy, usually starting before 9 weeks of pregnancy.

  Nutrients: Nourishing substances found in food, such as vitamins and minerals.

  Obstetric Care Provider: A health care professional who cares for a woman during pregnancy, labor, and delivery. These professionals include obstetrician–gynecologists (ob-gyns), certified nurse–midwives (CNMs), maternal–fetal medicine specialists (MFMs), and family practice doctors with experience in maternal care.

  Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.

  Thyroid Gland: A butterfly-shaped gland located at the base of the neck in front of the windpipe. This gland makes, stores, and releases thyroid hormone, which controls the body’s metabolism and regulates how parts of the body work.

Don’t have an ob-gyn? Search for doctors near you.

FAQ126

Published: May 2020

Last reviewed: December 2021

Topics:

Pregnancy
Pregnancy Discomforts and Other Concerns

Copyright 2023 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Treatment of nausea and vomiting in pregnancy

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Preginor® for toxicosis in pregnant women – Dr.Reddy’s official website

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Control of toxemia
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Preginor ^® is a carefully formulated complex of ginger extract, vitamin B6 and magnesium to control morning sickness in early pregnancy ^1,2,3 .

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Preginor ^® may be taken for early toxemia ^1,2,3 .

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Preginor ^® is produced in Russia in accordance with product safety requirements.

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The ginger extract in the Preginor ^® complex is produced in France and meets the requirements for quality and safety.

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Individual intolerance to the components is possible. Before use, according to the instructions, consultation ^1.2 is recommended.

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Ginger extract as part of Preginor ^® is standardized for the amount of gingerols that help achieve the effect

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^® with food, but I can’t eat because of nausea.

In case of toxicosis, pregnant women are recommended to have a snack in the morning, without getting out of bed, to reduce discomfort. A snack may include, for example, a banana or a cracker. Taking into account the recommendations, taking the Preginor ^® complex can be combined, for example, with a snack or a main meal ^1.2 .

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Preginor ^® can be taken for 1-2 weeks, it is possible to re-take in accordance with the instructions ¹ .

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According to observations in pregnant women with toxicosis, the use of ginger-containing complexes for at least 4 days may be associated with the likelihood of improvement in the condition. ⁴

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