Morning Sickness

 

A resume of the evidence compiled by Neil Pattison
 
Morning Sickness is the common in early pregnancy characterized by nausea, vomiting, tiredness, food intolerance.  Morning Sickness occurs in about 70% of women between 7-12 weeks of pregnancy and usually resolves by 14 weeks. In its severe form it is called hyperemesis gravidarum.
Morning Sickness is so common to be called normal and for most is fortunately mild. There is no need to be concerned about any effect on baby, nor does its presence signal the sex or health of baby.

FIRST STEP
For many women morning sickness can be minimized by minor changes in your lifestyle or diet.  Tiredness aggravates morning sickness so reducing activities helps if you are able.  Moving to five small bland meals a day will with time reduce symptoms.
Some women can reduce morning sickness by avoiding specific or most foods, although one must be careful to avoid dehydration. Others by eating more regularly, ie keeping food on board.  As morning sickness is a short term illness these approaches are usually safe and have no effect on you or your baby.

SECOND STEP
Vitamin B6 and ginger have been shown in controlled trials to reduce morning sickness and have no adverse effects.

THIRD STEP
There are three medical treatments which are not known to have any adverse effect on the fetus and have a long history for safety.
Cyclizine An antihistamine 50mg three times daily. This is mainly for nausea but for many is sedative.
Maxolon This is mainly for vomiting 5-10 mg three times daily with no side effects for most women.

FOURTH STEP
A new antinausea treatment is Zofran (Ondanstetron). It has a better efficacy history than the above medications but although there are excellent safety reports this drug has only been available for about 10 years so long term safety has not been established. It should be used only when others have failed.

HOSPITAL ADMISSION
Admission to hospital is fortunately rarely needed. However if vomiting leads to dehydration replacement intravenous fluid is indicated.

Additional information is available from the Royal College of Obstetricians
http://www.nhs.uk/conditions/pregnancy-and-baby/pages/severe-vomiting-in-pregnancy-hyperemesis-gravidarum.aspx
 
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