Monday 9 May 2011

Nausea & Vomiting in pregnancy

Most pregnant women will experience some degree of nausea and vomiting (NVP). It usually starts at about 6-8 weeks when the hormone levels are at its highest. Some 20%, the lucky few will not have this experience. You can tell if you will or will not experience NVP by whether you are prone to car or sea sickness!. Nevetheless if you get it it is a good sign in that the pregnancy is likely to be on going and the risk of miscarriage lower. The converse however does not hold true. If severe NVP is present this may sometimes be due to twin pregnancies!

If severe it can be quite debilitating and creates depression and worry whether the baby is getting sufficient nutrition. Overall the foetus is quite hardy and unless really severe to the point of dehydration, is unlikely to affect the foetus. You should initially try eating small meals several times a day, avoiding situations which might trigger off the NVP such as strong smells, noisy surroundings, certain foods. NVP is also called morning sickness but it rarely occurs in the morning and usually before or after midday. If you are able to after eating lying down often helps, or chewing on ice chips. Sea bands round the wrist from the pharmacy may help.

If more severe, your gyne may want to give you two medications that are the gold standard for treatment of NVP without side effects or effects on the foetus. Pyridoxine (vitamin B6) up to 40mg/day or a combination of pyridoxine and an antihistamine such as phenergan often will make alot of difference. It is the occasional patient who will require admission and an intravenous drip. Most NVP resolve by 12 weeks unless there are associated gastric and intestinal problems such as gastritis, gastric or duodenal ulcer.

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