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Morning sickness refers to the feelings of nausea during pregnancy and contrary to its name, it can be experienced by a woman at any time during the day. However, morning sickness symptoms are at the worst during mornings, which gets it the name. It is quite normal to have morning sickness, particularly during the first trimester of pregnancy. Almost two-thirds of pregnant women experience this. However, if your symptoms are severe and discomforting, it is important that you seek medical attention to determine other underlying factors. This article will familiarize you with the causes, symptoms, prevention and management of morning sickness to ensure your best pregnancy health.

  1. Morning sickness symptoms
  2. Causes and reasons for morning sickness
  3. Diagnosis of pregnancy morning sickness
  4. Prevention of morning sickness
  5. Morning sickness remedies and tips
  6. Morning sickness treatment
  7. Complications of morning sickness during pregnancy
  • The symptoms of morning sickness quite inadvertently include nausea and vomiting, which may be experienced at any time during the day or even the night. Usually, the symptoms are more pronounced early in the morning.
  • Some women may also experience headache and dizziness, while others generally feel sick without nausea or any apparent symptoms.
  • These symptoms usually begin 4 to 6 weeks after pregnancy and subside by the 12th or the 14th week. But for some, the symptoms may continue well within the fourth month. Also, some women may experience it throughout their pregnancy. But, do not worry, this is uncommon and is generally experienced by women carrying more than one foetuses.

It is important to note that these symptoms vary from woman to woman and even from one pregnancy to another. So if you are experiencing too much nausea in your first pregnancy, there is a chance that you may feel less sick in your subsequent pregnancy.

For some women, the symptoms may be quite severe causing them to vomit too often leading to weight loss and dehydration. It is important to visit your doctor in such cases.

There is no particular cause of morning sickness. It must be remembered that morning sickness is causing no harm to your pregnancy or the baby. It is a normal symptom which will slowly subside as you settle into pregnancy.

In fact, morning sickness is often a sign that your baby is doing quite well. The symptoms usually reflect that the placenta is forming all the hormones essential for optimal foetal growth and development.

Researchers have found that morning sickness helps in developing an adaptive mechanism and serves as an aid to a healthy pregnancy.

Several researchers have also reported that nausea and vomiting is a sign of good health in pregnancy and is indicative of a lesser risk of miscarriage. Following are a few associated factors of morning sickness:

  • Some experts believe that changes in hormonal levels during pregnancy is responsible for morning sickness in women, which is why it is experienced more severely during the first trimester.
  • Placental hormones are also somewhat responsible for causing morning sickness. Rapid increase in the levels of the placental hormone, human chorionic gonadotropin or HCG, is commonly associated with these symptoms.
  • Some also believe the heightened sense of smell during pregnancy to be responsible for morning sickness. It is quite obvious that in addition to the ever-changing hormones, being able to smell every food so strongly will make you feel queasy.
  • Severe symptoms of morning sickness are often associated with an underlying cause that is pathological, like, gastric reflux. In this condition, frequent nausea, heartburn and burning pain in the chest are quite commonly experienced due to the regurgitation of stomach acid contents into the oesophagus.
  • If you do not have gastroesophageal reflux disorder, severe nausea and vomiting could be a sign of hyperemesis gravidarum, which is an extreme form of morning sickness experienced by some women.

Risk factors of severe nausea and vomiting during pregnancy 

Following are the risk factors of severe morning sickness:

  • Researchers have found that nausea and vomiting during pregnancy are more intense in younger women and first-time mothers. They also found familial influence which means a woman is more likely to face severe nausea symptoms if she has a family history of this condition.
  • Women with an unhealthy diet and lifestyle prior to pregnancy, especially those who consumed a high-fat diet are at a greater risk.
  • Other than this, women with a previous history of motion sickness have a high risk of nausea due to the involvement of similar mechanisms.
  • Women who are either underweight or overweight are at a greater risk of severe morning sickness symptoms.

Morning sickness can easily be diagnosed from its symptoms and individual medical history along with pregnancy history.

HCG hormone in the blood and the urine are also used to diagnose morning sickness.

Morning sickness is an unavoidable symptom of pregnancy, but, it is possible to manage its severity. Following measures may prove to be helpful in reducing nausea during pregnancy:

  • Avoidance of triggers: for most women, certain foods and drinks are known to trigger the feeling of nausea. It is important that you recognise your individual triggers and avoid them to the best. Not just eating these foods, even the smell of these can be aggravating. So, it is advisable to stay away from your triggers.
  • Certain toothpaste and other dental products could also be a trigger for some. So, it is important to choose a mild toothpaste without any strong flavours.
  • Distance yourself from strong and pungent smells like perfumes, scented bath and grooming products.
  • Wear loose-fitting clothes during pregnancy to avoid excessive pressure on the abdomen, which could worsen the symptoms.
  • Avoid long distance travels, especially by a car.
  • Other than this, avoiding loud noises and bright lights may also be helpful.

So, now you know how not to trigger morning sickness but what exactly can you do to manage your symptoms? Here are a few tips:

  • Take a diet rich in proteins and carbohydrates along with low-fat dairy. Overall, make sure you have a healthy balanced diet.
  • Experts recommend eating before you feel hungry and before nausea kicks in. Staying hungry for a long time is likely to worsen your symptoms.
  • It is a better idea to consume short meals every few hours instead of taking a large meal and overeating.
  • Do not skip meals.
  • Eat any food that appeals to you and is nourishing but try to increase the intake of bland foods like potatoes, gelatin, broth and soups, as they help in soothing the stomach.
  • Eating a salt cracker or a slice of plain toast in the bed before waking up or if you tend to wake up in the middle of the night. Keep a bottle of water and a pack of salt crackers by your bed to indulge in this routine.
  • Eat more foods containing ginger like ginger tea, ginger candy and ginger ale. Taking ginger supplements may also be beneficial.
  • Mint is another such herb which may help with nausea symptoms.
  • Avoid the intake of high-fat foods.
  • Limit foods with a high salt/sodium content. For similar reasons, avoid packaged and processed food.
  • Avoid eating spicy foods.
  • Keep yourself hydrated: Consume lots of water and other fluids. You can have a glass of water when you feel nauseated to ease the symptoms. Drinking seltzer, ginger ale and other refreshing drinks can also help in the management of these symptoms.
  • You must consume water between the meals and not with the meal or immediately around it. This will make sure that you do not feel stuffed.
  • Other than these, it is recommended to avoid stress and have a better sleep to reduce feelings of nausea. Follow a healthy morning routine instead of rushing through your mornings.
  • Avoid smoking and keep away from those who smoke to prevent passive inhalation.
  • Stay away from poorly ventilated areas that trap food smells which might trigger nausea.
  • Vitamin B6 has been demonstrated to reduce nausea during early pregnancy. So, get in touch with your doctor to know its dosage and safety.
  • In some cases, benefits may be seen from indulging in alternative therapies like acupressure. Make sure to visit an acupressure specialist for pregnant women. Alternatively, you can buy acupressure wristbands easily available at health stores.
  • Sometimes, when the symptoms of nausea and vomiting are too intense, consider consuming an oral rehydration solution after consulting with your doctor. This will help to avoid dehydration and will aid in replenishing energy levels.

There is no specific approved treatment for the management of morning sickness. Medicines may help to improve the symptoms and prevent frequent nausea, so will the aforementioned foods and tips. As stated above, vitamin B6 may prove to be helpful. So, it is prescribed as a first-line treatment before any other agent. Other medicines and drugs for morning sickness include:

  • A combination of pyridoxine and doxylamine, which is the only FDA approved treatment of this condition.
  • Other than this, antiemetic agents are prescribed to reduce symptoms.
  • Antihistamines and anticholinergics may also be prescribed since it has been recognised that they help in suppressing vomiting centres in the brain.
  • If you experience heartburn and reflux along with nausea and vomiting during pregnancy, you may need an antacid in addition to the above agents.
  • Emotional support to the woman helps in managing the symptoms as it caters to stress reduction.
  • In women with severe symptoms like dehydration and weight loss, intravenous fluids and assisted nutrition are provided.

If you experience extreme nausea anytime during pregnancy, severe enough to make you feel dehydrated and lose some weight, it could be an indication of an underlying disorder or complication. These may also be a potential health threat to you and your baby, so, it is important to detect and manage them. Let’s have a look at these conditions:

Hyperemesis gravidarum

Hyperemesis gravidarum refers to extreme and persistent feelings of nausea and vomiting during pregnancy. This condition is quite uncommon and presents with the same symptoms of morning pregnancy, which are severe enough to cause dehydration, weight loss and electrolyte imbalance. This condition causes women to lose more than 5% of their total body weight.

Other symptoms of this condition include:

  • Dry skin
  • Generalised weakness
  • Feeling of faintness
  • Dark urine
  • Lightheadedness
  • Inability to take nutrition in any form, whether solid foods or liquid

Hyperemesis gravidarum is more common in women with twin pregnancies and those who are prone to motion sickness and it is even more severe in women with a hydatidiform mole (a non cancerous lump inside the uterus).

The treatment of hyperemesis gravidarum includes the administration of IV fluids to correct dehydration. Parenteral (intravenous) nutrition will also be provided in cases where the nutritional status of the woman is compromised.

In severe cases, antiemetics may be prescribed to manage nausea and vomiting.

Other than this, general measures to avoid nausea and vomiting go a long way in managing this condition.

Hyatidiform mole

Hydatidiform mole refers to a rare growth in the uterus at the beginning of pregnancy, which is caused due to an abnormal fertilisation of the egg resulting in an abnormal foetus.

Some of the symptoms of hydatidiform mole are:

Hydatidiform mole is manageable with surgical interventions to remove the abnormal structure and in severe cases, even the removal of uterus may be indicated. It is recommended to avoid getting pregnant for 6 to 12 months following a molar pregnancy to avoid its risk in subsequent pregnancies. The use of contraceptive must also be avoided during this duration.

References

  1. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy - morning sickness
  2. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Morning sickness
  3. healthdirect Australia. Morning sickness. Australian government: Department of Health
  4. Flaxman SM, Sherman PW. Morning sickness: a mechanism for protecting mother and embryo. Q Rev Biol. 2000 Jun;75(2):113-48. PMID: 10858967
  5. National Institutes of Health; [Internet]. U.S. Department of Health & Human Services; NIH study links morning sickness to lower risk of pregnancy loss.
  6. Noel M. Lee, Sumona Saha, Nausea and Vomiting of Pregnancy. Gastroenterol Clin North Am. 2011 Jun; 40(2): 309–vii. PMID: 21601782
  7. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Hyperemesis gravidarum
  8. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Hydatidiform mole
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