Nausea and vomiting in early pregnancy

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Morning sickness during pregnancy usually occurs from the 5th - 18th week of pregnancy. According to statistics, about 50-90% of women experience nausea during pregnancy, with or without vomiting. The severity and duration of nausea during pregnancy varies from woman to woman.

1. Distinguishing between morning sickness and severe morning sickness

Morning sickness is a term commonly used to describe mild pregnancy nausea and vomiting that is caused by pregnancy (and not by another illness). Morning sickness symptoms during pregnancy can occur at any time of the day. Severe morning sickness (Hyperemesis gravidarum) is a more serious condition that causes a pregnant woman to:
Vomit several times a day; Weight loss; Unable to consume food and liquids (broth, water, etc.); Must go to hospital for evaluation and drug treatment. 1.1. Morning sickness Vomiting and nausea during pregnancy usually appear in the 5th - 6th week of pregnancy. Symptoms are most severe around 9 weeks and will improve by 16-18 weeks of pregnancy. However, 15-20% of women still experience these symptoms into the third trimester and even until delivery (5% of women). Although mild pregnancy-related nausea and vomiting usually occurs in the morning, it can happen at any time of day. Many women (80%) feel nauseous throughout the day or even at night. It should be noted that women with mild nausea and vomiting during pregnancy are less likely to have miscarriages and stillbirths than women without these symptoms.
1.2. Severe morning sickness This is severe nausea and vomiting during pregnancy. Women with severe morning sickness often vomit every day and may lose more than 5% of their pre-pregnancy body weight. In most cases, women with this syndrome also experience dehydration, as well as deficiencies in vitamins and other nutrients.

2. Causes of morning sickness during pregnancy

The cause of pregnancy-related nausea and vomiting is unclear. Increased hormone levels, slow movement of gastric contents, genetic predisposition and psychological factors... are common theories that cause morning sickness during pregnancy but have yet to be proven.
Some women are more likely to experience morning sickness during pregnancy, including those who:
Have had these symptoms in a previous pregnancy; Nausea and vomiting with estrogen (eg, in oral contraceptives) or menstrual migraines; Travel sickness ; Have family members (especially sisters or mothers) also experience morning sickness during pregnancy; a history of gastrointestinal problems (reflux, ulcers); Twins, triplets or multiples; Egg pregnancy (egg pregnancy).

3. Morning sickness when to see a doctor?

Many women, especially those with mild to moderate nausea and/or vomiting that don't need medical treatment, should let their obstetrician know about their pregnancy symptoms. Your doctor will then recommend ways to help relieve your symptoms or determine if drug treatment is warranted. Also, talk to your obstetrician-gynecologist if you have one or more of the following:
Signs of dehydration, including infrequent urination, dark urine, or dizziness when standing; Nausea and vomiting during pregnancy several times a day, especially if you see bloody vomit; Abdominal/pelvic pain or cramps; Vomiting all food or drink within 12 hours of intake; Weight loss of more than 5 pounds (2.3 kg); Fever or diarrhea with vomiting and nausea during pregnancy; Feelings of hopelessness, wanting to end the pregnancy, or having suicidal thoughts because the level of morning sickness during pregnancy is too severe. Your doctor may recommend one or more tests to investigate the cause and determine the severity of the problem, including: Blood tests, urinalysis, or ultrasound.

4. Treatment of morning sickness during pregnancy

Women can manage nausea and vomiting during pregnancy with home remedies (diet and lifestyle changes), as well as available prescription or over-the-counter medications.
You may have to try several or a combination of treatments over the last few weeks to find the one that works best for you. The feeling of vomiting and nausea during pregnancy often cannot be completely eliminated, but only reduced so that you can eat and drink enough for the development of the fetus, as well as ensure the quality of life. Fortunately, morning sickness symptoms usually go away on their own by mid-pregnancy.
4.1. Dietary changes Vomiting and nausea during pregnancy can be made worse by overeating or excessive hunger. So, try to eat before or as soon as you feel hungry to avoid hunger pangs. Snack often and eat small meals (eg, 6 small meals/day) that are high in protein or carbohydrates and low in fat. Binge eating can also be a good idea if you have morning sickness during pregnancy. Drink some cold and carbonated or sour water (eg: Ginger beer, lemonade) between meals. Smelling fresh lemon, mint, or orange or using an essential oil diffuser with these scents can also help.
4.2. Avoiding nausea and vomiting during pregnancy One of the most important treatments for nausea and vomiting during pregnancy is to avoid smells, tastes, and activities that trigger nausea during pregnancy. Some women find it easier to eliminate spicy foods. Other examples of pregnancy nausea triggers include:
Stuffy room; Odors (eg: Perfume, chemicals, coffee, food, smoke); Heat and humidity; Noise; Visual or physical movements (e.g. flashing lights, driving); Excessive exercise; Excessive salivation (drooling disease); Excessive fatigue or feeling tired; Foods and snacks that are high in sugar; Spicy foods and high-fat foods. Brushing your teeth after eating can help prevent morning sickness during pregnancy. If you experience severe nausea while taking vitamins along with iron, try taking it before bed. If symptoms persist, temporarily stop taking the vitamin and let your obstetrician know. Your doctor may recommend another vitamin or supplement containing 400-800 micrograms of folic acid for you to take until week 14 of pregnancy to reduce the risk of birth defects in your unborn baby.
4.3. Complementary treatments The following treatments may be helpful in some cases of morning sickness during pregnancy:
Acupuncture and acupressure; Hypnosis and counseling (may be helpful for women with a history of anxiety or depression); Ginger powder or ginger tea and foods containing ginger (eg, ginger candy, ginger beer) may help relieve mild nausea and vomiting in some women; Use a nasogastric tube or parenteral nutrition. 4.4. Medicines Nausea and vomiting medications are effective in some women and are safe to take during pregnancy. However, you must ask your doctor before taking any over-the-counter or prescription medications, including nutritional and herbal supplements.
Vitamin B6 and doxylamine; Antihistamines and other anti-nausea medications during pregnancy; Diphenhydramine/ Benadryl (may cause drowsiness); Meclizine/Dramamine (may cause drowsiness); Promethazine/Phenergan (may cause drowsiness and dry mouth); Metoclopramide/ Reglan; Ondansetron/Zofran (not recommended in patients with QT prolongation; constipation is also a side effect of ondansetron); Prochlorperazine/Compazine (may cause drowsiness and dry mouth, should be avoided in patients prone to QT prolongation); Corticosteroids/Solu-Cortef, dexamethasone (for women who have not responded to the medications listed above). Most women with pregnancy-related nausea and vomiting make a full recovery without any complications. Women with mild to moderate vomiting tend to gain less weight during early pregnancy. Weight gain during pregnancy occurs in the second half of pregnancy, after the nausea and vomiting associated with pregnancy have stopped. Women who did not experience severe nausea and vomiting during their first pregnancy are less likely to develop it in subsequent pregnancies.

In summary, morning sickness is a condition that often occurs in the first 3 months of pregnancy, this is also the most sensitive time, for mother and baby to be healthy, it is important to note:
Understand the early signs of pregnancy pregnancy , pregnancy poisoning , bleeding in pregnancy . Timely, correct and sufficient first prenatal check-up, avoiding too early/too late. Fetal malformation screening at 12 weeks detects dangerous fetal malformations that can be intervened early. Differentiate between normal vaginal bleeding and pathological vaginal bleeding for timely intervention to maintain pregnancy. Screening for thyroid disease in the first 3 months of pregnancy avoids dangerous risks before and during delivery. Vinmec currently has many maternity packages (12-27-36 weeks), in which the 12-week maternity package helps monitor the health of mother and baby right from the beginning of pregnancy, early detection and timely intervention of health issues. In addition to the usual services, the maternity monitoring program from 12 weeks has special services that other maternity packages do not have such as: Double Test or Triple Test to screen for fetal malformations; Quantitative angiogenesis factor test for preeclampsia; thyroid screening test; Rubella test; Testing for parasites transmitted from mother to child seriously affects the baby's brain and physical development after birth.
For more information about the 12-week maternity package and registration, you can contact the clinics and hospitals of Vinmec health system nationwide.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.

Reference sources: msdmanuals.com, uptodate.com