Did you like this article?
Please share it with the world
Morning sickness is a complaint that usually occurs during pregnancy and includes symptoms such as vomiting and nausea. It does not necessarily occur in the morning, but at any time of the day or night. It is most common in pregnancy during the first trimester but, in a few cases, it may occur during the whole pregnancy period. It is usually the first sign a woman observes at the start of pregnancy, distressing more than 80% of women during their pregnancy period. Women taking hormone replacement therapy or hormonal contraceptives may also experience morning sickness.
Morning sickness can be relieved by home remedies such as sipping ginger ale, over-the-counter medications, and taking healthy snacks throughout the day. In rare cases, morning sickness takes a much more serious form known as hyperemesis gravidarum. In hyperemesis gravidarum, vomiting and nausea result in severe dehydration and weight loss, which may be more than 5 percent of the weight of the woman before the start of pregnancy. If it reaches emergency level, hyperemesis gravidarum may require hospitalization during pregnancy to receive intravenous fluids to combat dehydration, medications, and sometimes a feeding tube.
Morning sickness is an uncomfortable and irritating condition, but it poses no health risk to the mother or fetus. It is a physiological process of pregnancy and some researches have proven that it is a sign of a normal and healthy pregnancy.
Some studies show that pregnancies in which morning sickness occurs have less risk of stillbirths and miscarriages.
The common cause of morning sickness in pregnancy is a change in the levels of hormones in the body. The most common hormones include progesterone, estrogen, and human chorionic gonadotropin (hCG). Other causes may include changes in blood sugar levels and sense of smell.
Estrogen levels increase by approximately one hundred percent in pregnant women as compared to non-pregnant women. However, there is no evidence of a difference in the levels of estrogen circulating in pregnant women who have morning sickness and those who do not have morning sickness. Additionally, one of the main roles of increased progesterone levels during pregnancy is to relax the muscles of the uterus to prevent preterm labor and early childbirth. An increase in progesterone levels may also relax the muscles in the stomach and bowel, causing more acid secretion from the stomach cells and acid reflux. HCG is produced by the developing embryo and placenta at different stages of pregnancy. Some experts propose that morning sickness has an association with hCG.
Hypoglycemia, caused by increased transport of glucose from the mother’s body to the fetus via the placenta, may cause decreased energy levels. A decrease in energy levels can also cause nausea and vomiting in pregnancy. Pregnancy may cause an increase in sensitivity to odors that may overstimulate normal nausea stimulus.
Symptoms of morning sickness typically include vomiting and nausea, commonly during the early months of pregnancy. In some cases, symptoms of morning sickness may become severe and may also be associated with other symptoms, including:
Usually, symptoms of morning sickness improve after twelve weeks of pregnancy, but in some cases may persist for the whole duration of the pregnancy/
Morning sickness starts in the 6th week of pregnancy and lasts until about the 12th week. Symptoms of morning sickness are at a peak between 8 to 10 weeks. According to many studies, almost 50 percent of pregnant women feel free from morning sickness at about the 14th week of pregnancy or at the beginning of the second trimester. The same studies also revealed that 90 percent of pregnant women had settled morning sickness by 22 weeks. Additionally, pregnant women who experience nausea and vomiting during the eighth week have a decreased risk of miscarriage by about 50 percent.
Morning sickness is not restricted to the morning only; it may also occur throughout the whole day or night. Only two percent of pregnant women feel morning sickness only in the morning. However, if you went to sleep hungry, there is an increased risk of vomiting and nausea in the morning after waking up. Some health professionals have changed the name of morning sickness and now call it NVP, or nausea and vomiting during pregnancy.
If morning sickness does not last a typical amount of time or symptoms become severe, it may be a complication of morning sickness known as hyperemesis gravidarum. This usually occurs in about 0.5 to 2 percent of pregnancies. This condition is the second most common reason for hospitalization in pregnant women. Most cases of hyperemesis gravidarum recover at the 20th week of pregnancy, but 22 percent of cases resolve after the termination of pregnancy.
Women who suffer from hyperemesis gravidarum once have increased risk in future pregnancies. Other risk factors include:
If you have symptoms of morning sickness, your physician may ask for some investigations to confirm the diagnosis. In the case of pregnant women, the doctor may order some tests to rule out any maternal or fetal disorder. All the investigation that may be required include:
Urine tests help to determine dehydration, normal amounts of specific hormones that are secreted in urine during pregnancy, and creatinine levels.
Blood chemistry tests include a complete blood count and comprehensive metabolic panel (Chem-20). These tests will check out the electrolytes in the blood, malnourishment, dehydration, deficiency of certain vitamins, and anemia.
Ultrasound is used to investigate the normal growth and development of your baby with the help of images produced by sound waves.
Morning sickness can be relieved with lifestyle measures and home remedies. Medical treatment is also available for treating morning sickness.
Several alternative remedies can help protect you against morning sickness, including:
In mild cases, medical treatment is not required. However, in case of severe symptoms or extreme discomfort, your doctor may prescribe B-6 supplements (pyridoxine), ginger, and over-the-counter medications such as doxylamine. Anti-nausea drugs such as ondansetron and promethazine are safe to use during pregnancy and commonly prescribed by the doctors.
Diclegis is an FDA-approved medication for use in pregnancy. One clinical study determined that Diclegis relieved nausea completely in more than 40 percent of pregnant women with morning sickness. Another trial concluded that about 70 percent of women showed improvements in morning sickness symptom.
In moderate or severe vomiting and nausea, dehydration may occur causing the loss of electrolytes such as potassium and sodium. In such cases, oral or intravenous fluids, along with prescription drugs, may have a significant role in relieving the symptoms.
Your doctor will ask about how many times you have vomited, the frequency of nausea, whether you have consumed extra fluids, and whether you have practiced home remedies. Your doctor will recommend medications for symptoms of morning sickness that are safe in pregnancy.
Also, consult your physician before taking any supplement or over-the-counter medications during pregnancy. If you have hyperemesis gravidarum, you may need emergency treatment or hospitalization. Treatment involves intravenous fluids and anti-nausea medications.
 Bustos, M., Venkataramanan, R., & Caritis, S. (2017). Nausea and vomiting of pregnancy – What’s new?. Autonomic neuroscience : basic & clinical, 202, 62–72. https://doi.org/10.1016/j.autneu.2016.05.002
 Gadsby, R., Barnie-Adshead, A. M., & Jagger, C. (1993). A prospective study of nausea and vomiting during pregnancy. The British journal of general practice : the journal of the Royal College of General Practitioners, 43(371), 245–248.
 Frese, T., Klauss, S., Herrmann, K., & Sandholzer, H. (2011). Nausea and vomiting as the reasons for encounter in general practice. Journal of clinical medicine research, 3(1), 23–29. https://doi.org/10.4021/jocmr410w
 Mosa, A., Hossain, A. M., Lavoie, B. J., & Yoo, I. (2020). Patient-Related Risk Factors for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Frontiers in pharmacology, 11, 329. https://doi.org/10.3389/fphar.2020.00329
 Chan, R. L., Olshan, A. F., Savitz, D. A., Herring, A. H., Daniels, J. L., Peterson, H. B., & Martin, S. L. (2011). Maternal influences on nausea and vomiting in early pregnancy. Maternal and child health journal, 15(1), 122–127. https://doi.org/10.1007/s10995-009-0548-0
 Chan, R. L., Olshan, A. F., Savitz, D. A., Herring, A. H., Daniels, J. L., Peterson, H. B., & Martin, S. L. (2010). Severity and duration of nausea and vomiting symptoms in pregnancy and spontaneous abortion. Human reproduction (Oxford, England), 25(11), 2907–2912. https://doi.org/10.1093/humrep/deq260
 Viljoen, E., Visser, J., Koen, N., & Musekiwa, A. (2014). A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutrition journal, 13, 20. https://doi.org/10.1186/1475-2891-13-20
 Matthews, A., Dowswell, T., Haas, D. M., Doyle, M., & O’Mathúna, D. P. (2010). Interventions for nausea and vomiting in early pregnancy. The Cochrane database of systematic reviews, (9), CD007575. https://doi.org/10.1002/14651858.CD007575.pub2
 Khorasani, F., Aryan, H., Sobhi, A., Aryan, R., Abavi-Sani, A., & Ghazanfarpour, M. et al. (2019). A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy. Journal Of Obstetrics And Gynaecology, 40(1), 10-19. https://doi.org/10.1080/01443615.2019.1587392
 Einarson, A., Maltepe, C., Boskovic, R., & Koren, G. (2007). Treatment of nausea and vomiting in pregnancy: an updated algorithm. Canadian family physician Medecin de famille canadien, 53(12), 2109–2111.
Go ahead and choeck out our newest articles.