Pregnancy Vomiting

Symptoms

Complaints include nausea and/or vomiting, which in a minority occur only in the morning, and in the majority also during the day. Because of throat irritation, additional throat clearing and coughing are often observed and, in a severe course, tightening of the rib muscles.

Course

For most pregnant women, normal, self-limiting symptoms with no health effects for mother or fetus. For children born to women with vomiting during pregnancy, there is even a lower risk of miscarriage, according to some studies. The symptoms usually disappear by the 16th week of pregnancy, but persist throughout pregnancy in up to 20%. The severe form, hyperemesis gravidarum, can lead to health problems for both mother and baby (see Complications).

Cause

The exact cause is not known. Discussions include psychological disposition, evolutionary adaptation, hormonal triggers (especially HCG), and Helicobacter pylori infection. Some women react to certain triggers such as smell (e.g., perfume, food), loud noises, or pressure on the abdomen.

Complications

Possible complications include moodiness and depression and decreased performance at home and at work. Medications given at the same time may not be absorbed. Multivitamin supplements such as Elevit should be taken temporarily during pregnancy vomiting, for example, at noon or in the evening, to ensure absorption of the substances. Hyperemesis gravidarum: The severe form of pregnancy vomiting, hyperemesis gravidarum affects about 0.3-3% of pregnant women. It can lead to dehydration, electrolyte imbalances, vitamin deficiencies, and maternal weight loss, and may require hospitalization. It can lead to complications in both mother and child and should be adequately treated.

Diagnosis

It is important to keep in mind that nausea and vomiting early in pregnancy can have many other causes, for example, gastroenteritis, hepatitis, ulcer disease, or pancreatitis.

Nonpharmacologic treatment

Before drug treatment, nonmedication behavioral changes should be tried. Avoid triggers (see above). Dietary measures:

  • If vomiting occurs, consume adequate fluids to avoid dehydration.
  • Eat small meals spread throughout the day, prefer bland food, cookies, carbohydrates.
  • Salty food is tolerable (e.g. crackers, boiled potatoes). Crackers put on the nightstand and eat first thing in the morning.
  • Avoid highly spiced, fatty and strong-smelling meals.

Lifestyle:

  • Avoid stress, rest frequently, shorten workdays.

Emotional support alternative medicine:

  • Acupuncture and acupressure at the acupoint P6 can bring a women relief. For this purpose, among other things, acupressure bracelets are on sale (eg Sea Band). The acupoint P6 is located on the inside of the wrist. Every 4 hours, a pressure is applied for 5 minutes.

Drug treatment

Medication should be dispensed as prescribed by a physician. 1st generation antihistamines:

Vitamins:

  • Pyridoxine (vitamin B6) is approved alone or in combination with meclozine or doxylamine for pregnancy vomiting. It is also included in multivitamin preparations for pregnancy, but in them in low doses.
  • Taking multivitamin preparations can also have a positive effect.

Herbal medicines:

  • Ginger is a well-known spice and herbal antiemetic, but is not approved for this use in many countries (Zintona is contraindicated in pregnancy according to the package insert). Scientifically, ginger has not yet been adequately studied. Negative effects on the fetus, however, have not been observed so far.

Ondansetron is NOT recommended because of the risk of developing congenital malformations.In our view, this also applies to other serotonin antagonists. Hyperemesis gravidarum: Under specialist treatment. Depending on severity, fluid and food replacement, vitamins, and antiemetics; possibly hospitalization.