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Monday, December 13, 2010

Causes And Treatment Of Pregnancy Induced Vomiting : Morning Sickness AND Hyperemesis Gravidarum

Vomiting is a hallmark of First Trimester ( first three months ) Of Pregnancy. How It can be prevented and Treated ???

“Morning Sickness” is the most common term used to describe the nausea that often comes during the first three months of pregnancy. Known medically as “Nausea and Vomiting of Pregnancy” (NVP), it is best described as episodic, daytime pregnancy nausea and vomiting. - Although it occurs most commonly after waking in the morning, for many pregnant women it can happen all day.

The most severe form of morning sickness is known as Hyperemesis Gravidarum [emesis means vomiting, gravidarum means pregnancy] , where persistent vomiting leads to dehydration and weight loss.

Causes Of  Pregnancy Induced Vomiting

The exact cause of nausea and vomiting in pregnancy is not clear. Most evidence points to rapid changes in hormone levels. These fluctuations may cause changes in the muscle contraction and relaxation patterns of your stomach and intestines, thus leading to nausea and vomiting.

The hormones that seem to have the most to do with this process include the pregnancy hormone human chorionic gonadotropin (hCG), estrogen, and progesterone. Abnormal levels of thyroid hormones have also been reported in women with severe vomiting, although a cause-and-effect relationship remains unclear. Some studies have shown that nausea is worse when your blood sugar level is low.

Treatment Of  Pregnancy Induced Vomiting
Possible treatments might include:
  •   Preventive measures:  These might include a pressure-point wristband , vitamin B6, and/or ginger.
  •   Small frequent meals:  Nausea and vomiting might be treated with dry foods (such as crackers), small frequent meals, and emotional support.
  •    Inrtavenous Fluids:     It is important for a pregnant woman to maintain her fluid intake. IV fluids might be needed if a woman continues to vomit throughout pregnancy. In severe cases, the woman might require hospitalization and given IV fluids. IV fluids might be discontinued when a woman is able to take in fluids by mouth.
  •   Total parenteral nutrition:  The most severe cases of hyperemesis gravidarum might require that complex, balanced solutions of nutrients be given through an IV throughout pregnancy. This is called total parenteral nutrition (TPN).
  •    Medicines: Medicine to prevent nausea is used when vomiting is persistent and poses possible risks to the mother or baby. If a woman cannot take medicines by mouth, the drugs might be administered through an IV or a suppository. Medicines used to prevent nausea include Promethazine, Meclizine, and Droperidol.

Department of Obstetrics and Gynecology,
Rawalpindi Medical College, Rawalpindi,


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