Vomiting in pregnancy - Morning sickness

Vomiting of Pregnancy , Morning Sickness & Hyperemesis Gravidarum (Pernicious Vomiting of Pregnancy)

Featured with nausea and vomiting either Morning or evening in pregnant women. Relentless vomiting severe enough to produce loss of weight, dehydration, starvation ketosis, hypochloremic alkalosis, and hypokalemia. Liver enzymes may be raised transiently. Seems to be associated with high or rising serum hCG ( Human chorionic gonadotrophin). More frequent and severe with multiple gestation (twins) or hydatidiform mole.


Nausea and vomiting start just following the first missed period and stop by the fifth month of pregnancy. Up to 75% of women complain of nausea and vomiting during their early part of pregnancy, and most of them complain nausea all through the day. This does not have any deleterious effects on the pregnancy and does not foretell or lead to any other complications.
Persistent, severe vomiting during pregnancy is a condition is known as hyperemesis gravidarum. This is really a disabling situation and requires hospitalization. Sometimes thyroid dysfunction is associated with hyperemesis gravidarum. Thyroid hormone profile should be done in such cases.

Treatment of morning sickness of pregnancy:

Reassurance and dietary recommendation solve the problem in the majority of women.Because of potential risk of teratogenicity, medications during the first half of pregnancy should be limited to those of vital importance to life and health. Antiemetics, antihistamines, and antispasmodics are in general needless and not useful much for nausea of pregnancy. Vitamin B6 (pyridoxine), 50–100 mg/day orally, is harmless and usually helpful in some patients.

Treatment of Hyperemesis Gravidarum

Hospitalization in a private room with nil or very restricted visitors solve the problem in many patients. If this fail to improve the situation, then nothing is given by mouth for 48 hours, and hydration and electrolyte balance is maintained by giving appropriate IV fluids and vitamin supplements as required. Hardly ever, total parenteral nutrition (TPN) may become needed. As soon as possible, she is shifted to a dry diet consisting of six small feedings daily plus clear liquids one hour after eating the solid food. Prochlorperazine rectal suppositories may be necessary sometimes.