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A. Nausea and vomiting is a symptom of pregnancy and affects most women to some degree.
It begins early in pregnancy, most commonly between the 4th and 7th week.
It usually settles by 12–14 weeks, although in some women it may last longer.
It is often called ‘morning sickness’ but it can occur at any time of the day or night.
A. The cause is thought to be pregnancy hormones but it is unclear why some women get it worse than others.
However, it is more likely if:
It is important that other causes of vomiting are considered and looked into, particularly if you are unwell, have pain in your tummy or your vomiting only starts after 10 weeks of pregnancy.
Possible other causes include gastritis (inflammation of the stomach), a kidney infection, appendicitis or gastroenteritis.
A. If the nausea and vomiting become so severe that they lead to dehydration and significant weight loss, it is known as hyperemesis gravidarum. It may affect 1 to 3 in 100 pregnant women.
Signs of dehydration include:
Women with this condition may need to be admitted to hospital.
In severe cases, vomiting can last up to 20 weeks. Occasionally, it can last until the end of pregnancy.
A. Nausea and vomiting of pregnancy can be a difficult problem to cope with.
It can affect your mood, your work, your home situation and your ability to care for your family.
In some women, the symptoms can be so severe that they become depressed and need extra support such as counselling.
If you find that you persistently feel down then you should speak to your obstetrician.
A. There is no evidence that nausea and vomiting have a harmful effect on your baby. In fact, you have a slightly lower risk of miscarriage.
Women with severe nausea and vomiting or with hyperemesis gravidarum may, however, have a baby with a lower than expected birthweight. You may be offered scans to monitor the growth of your baby.
A. Most women with nausea and vomiting of pregnancy will be able to manage their symptoms themselves.
You should:
If your symptoms do not settle or if they prevent you doing your day-to-day activities, see your obstetrician, who will prescribe anti-sickness medication. This is safe to take in pregnancy.
A. Contact your obstetrician.
You will have a check-up that may include:
If you are able to tolerate some fluids but are unable to drink enough, you should be offered fluids through a drip in your arm over a short period of time. This is called rapid rehydration. You will also be given anti-sickness medication. Many women feel much better after this and are able to go home.
A. Admission to hospital may be advised if you:
A. You will be given the fluids you need though a drip in your arm. This will be continued until you are able to drink fluids without vomiting.
Each day your fluid intake and how much urine you are passing will be recorded. Your temperature, blood pressure, pulse, respiratory rate and weight will also be recorded.
You should be offered:
If you are taking iron medication, this will be stopped because it can make sickness worse.
When you are feeling better, you can start to drink and eat small amounts and slowly build up to a normal diet.
A. There are a variety of anti-sickness medicines that you may be offered.
Cyclizine is the medication that is usually given first. It can be taken in tablet form or by an injection. Prochlorperazine and metoclopramide can be tried if cyclizine has not worked. All three of these medications are considered to be safe in pregnancy.
A. Corticosteroids may be considered if:
Corticosteroids are successful in many women where all other measures have failed.
Most women will be able to stop corticosteroids by 18–20 weeks but 1 in 5 women will need to continue them at a low dose for the rest of the pregnancy.
Only a tiny amount of the corticosteroids used to treat hyperemesis gravidarum passes from you to your baby and they are generally considered safe for use in pregnancy.
If hyperemesis gravidarum is not treated, it may cause more harm to the baby than any possible effects of a medicine recommended by your doctor.
A. You will be given anti-sickness tablets to take home. If you feel better, you can cut down the number of tablets. If your vomiting gets worse, stop eating but try to keep sipping fluids and taking the anti-sickness tablets until you start to feel better.
Your symptoms may return and you may become dehydrated. If this happens, contact your obstetrician to be assessed again.
Although this can be a difficult situation for you and may affect you throughout your pregnancy, the symptoms usually resolve or improve after your baby is born.
A.