I enjoyed seeing just how many euphemisms there are for vomiting on this webpage: http://jakersdelight.blogspot.com/2009/08/vomit-euphemisms.html. Every pregnant woman knows, however, that there's nothing funny about the nausea (aka "morning sickness") that affects most women at some point during pregnancy. Some of us can suffer for half or more of the pregnancy, while most women peak at 7--12 weeks then find that the symptoms decrease and then disappear. So what's to be done about it? Well, if there's just nausea but no vomiting it is certainly reasonable to try just modifying one's diet to foods that seem to agree with them (which will be different for everyone, but typically bland foods low in fat and higher in carbs work for many). Vitamin B6 or pyridoxine, 100mg daily, can also be helpful. Some women also try "sea-bands" and accupuncture to help themselves. Sipping lemonade or sucking on lemon drops can take away some of that bad taste women frequently complain about. Being careful during tooth brushing not to stimulate too much retching is also a challenge, but a fluoride mouthwash can help you keep up with your oral hygiene.
I tell my patients that some weight loss is not as concerning in the beginning as is dehydration. If a patient calls with an inability to hold down fluids for more than 12 hrs, I usually have them come to the hospital for IV hydration in order to help break the cycle of nausea and vomiting that can often ensue from getting dehydrated. This is true both for pregnancy-related nausea and vomiting, as well as gastroenteritis or food poisoning. Late in pregnancy the dehydration can also cause preterm contractions, which is another reason we like to intervene sooner than later.
Medications that we use for nausea in pregnancy include promethazine or Phenergan, Reglan, and Zofran. Promethazine can be sedating and Zofran can cause constipation, so being prepared for side effects is a good thing. In extreme cases we occassionally hospitalize patients and even more rarely send them home with long-term intravenous nutrition formulas for home infusion. Having severe nausea can also lead to depression, so we monitor these patients closely for those signs and symptoms too.
The good news is that the reason many women suffer with nausea is that the level of their hormones is nice and high, often an indicator of a normally developing pregnancy. All pregnancies are associated with a plateau in these levels around 10 wks or so, and that's why most women can expect their symptoms to wane shortly thereafter.
I tell my patients that some weight loss is not as concerning in the beginning as is dehydration. If a patient calls with an inability to hold down fluids for more than 12 hrs, I usually have them come to the hospital for IV hydration in order to help break the cycle of nausea and vomiting that can often ensue from getting dehydrated. This is true both for pregnancy-related nausea and vomiting, as well as gastroenteritis or food poisoning. Late in pregnancy the dehydration can also cause preterm contractions, which is another reason we like to intervene sooner than later.
Medications that we use for nausea in pregnancy include promethazine or Phenergan, Reglan, and Zofran. Promethazine can be sedating and Zofran can cause constipation, so being prepared for side effects is a good thing. In extreme cases we occassionally hospitalize patients and even more rarely send them home with long-term intravenous nutrition formulas for home infusion. Having severe nausea can also lead to depression, so we monitor these patients closely for those signs and symptoms too.
The good news is that the reason many women suffer with nausea is that the level of their hormones is nice and high, often an indicator of a normally developing pregnancy. All pregnancies are associated with a plateau in these levels around 10 wks or so, and that's why most women can expect their symptoms to wane shortly thereafter.
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