Nausea and Vomiting in Pregnancy

Posted On: December 21, 2017 By Daniel Saltzman, MD

Nausea and vomiting are very typical symptoms women experience early on in pregnancy. In this blog, we will explain the implications of these symptoms. 50% of women have nausea and vomiting in early pregnancy and 25% have nausea alone. In about 35% nausea and vomiting are clinically significant, resulting in lost work time and negatively affecting family relationships.

When do Symptoms Start?

Gestational age at onset is 6 weeks from the first day of a pregnant woman’s last menstrual period. This is 4 weeks from conception. Peak severity is 11-13 weeks which is the end of the first trimester. Nausea resolves in 60% by the end of the first trimester and in 91% of women by 20 weeks. Another term for nausea and vomiting is “morning sickness” but nausea lasted all day long in 80% of women

Do These Symptoms Affect the Pregnancy?

In a small minority of patients,0.3-1.0% the symptoms lead to dehydration and weight loss requiring hospitalization. This is the most severe form This is usually termed hyperemesis gravidarum. This is associated with some adverse pregnancy outcomes such as low birth weight babies (weighing less than 5lbs 8 oz) and small for gestational age babies (babies whose weight is less than the 10th percentile for their gestational age (the number of weeks that they are pregnant) and are more likely to deliver prematurely. There is no association with increased birth defects or death during or up to 28 days after birth.

Facts About Nausea and Vomiting in Pregnancy

  • Nausea and vomiting is associated with a DECREASED risk of miscarriage
  • Women with twins are at higher risk of having nausea and vomiting and these symptoms are an indication for an ultrasound to see if an explanation such as twins can be found
  • Although it has been suggested that nausea and vomiting may be caused by psychological factors there is no good data to support this
  • Onset of nausea and vomiting after 8 weeks gestation is rare in pregnancy
  • A woman should be advised to avoid exposure to odors and food or supplements that appear to trigger nausea. Common triggers include fatty or spicy foods and iron tablets
  • Eating small amounts of food several times a day and drinking fluid between meals as well as bland, dry and high protein foods may be helpful. Protein predominant meals reduce nausea more than meals containing equal carbs and fats or noncaloric meals
  • 10% of women with nausea and vomiting in pregnancy require medication. A combination of oral vitamin B6 25-50 mg and an antihistamine doxylamine (Unisom sleep tabs cut in half 12.5 mg) which is over the counter is associated with a 70% reduction in nausea and vomiting. It is recommended by ACOG (American Congress of Ob-Gyn ) as first-line therapy It can be gotten as a prescription from your provider it is called Diclegis
  • Ginger may ease symptoms nausea and vomiting in pregnancy.

Speak with your obstetric provider to discuss the best way to manage your nausea and vomiting.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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