Vomiting in pregnancy: an unpleasant but "normal" malaise
Vomiting in pregnancy is a very frequent phenomenon: only rarely does it hide some major problem, but in most cases it is completely normal. However, there are many remedies and good rules to avoid the classic nausea when you are expecting. It goes without saying that nutrition during pregnancy is really important: find out all the foods to avoid and those to focus on during the 9 months of pregnancy! Watch the video!
Nausea and vomiting: it takes patience!
Pregnancy-dependent vomiting begins in the first trimester, occurs for a few weeks, is not associated with abdominal pain or other intestinal problems. Nausea is a very common symptom especially in early pregnancy. Perhaps it is the first to manifest itself, between the fifth and eighth week of gestation, very often combined with a strong annoyance for odors and a very altered taste of flavors. If in the first pregnancy the woman suffered from this disorder, it is very likely that she will also suffer from it in the following ones. And especially if it is a question of twin pregnancies and if the pregnancy is complicated by vesicular mola. Both of these situations raise the level of chorionic gonadotropin (beta-HCG), which is believed to be responsible for this annoying disorder. Women who are allergic to perfumes or suffer from seasickness and car but those who periodically experience migraines more easily can experience nausea and vomiting in gestation. And so have those who suffer from gastroesophageal reflux and gastrointestinal diseases. Among other things, estrogen and progesterone tend to relax the intestinal muscles and therefore also the sphincter, the cardia, between the stomach and the esophagus, the valve that prevents the ascent of acid from the stomach, but which when it does not work favors a greater esophageal reflux. There is talk of nausea as morning sickness, but also of evening nausea; unfortunately in some cases this disorder can arise many times in the same day. According to some studies, nausea is more frequent if the fetus is a girl. Vomiting and severe nausea affect up to 50% of pregnant women, while hyperemeresis gravidarum with very frequent vomiting and persistent symptoms about 1.25 . The association of nausea and diarrhea in pregnancy is infrequent; constipation, on the other hand, manifests itself more, due to the muscles of the intestine relaxed by hormones. If vomiting and diarrhea occur together, the increased risk of dehydration must be taken into account.
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Hyperemesis gravidarum: the causes
This medical definition is a rather serious form of vomiting in pregnant women. For some of them, nausea and vomiting are persistent disorders, which involve the loss of body fluids: we therefore speak of hyperemesis gravidarum, which can also cause a significant weight loss and dehydration. Women with this disorder do not absorb sufficient energy through food, so the body degrades fats resulting in the accumulation of waste products (ketones), a situation called ketosis. When fasting for a certain time, the body draws energy from fats, not having sufficient reserves of glycogen. This leads to the production of ketones, which are acids that go into the blood and are disposed of in the urine. production and their concentration have harmful effects on health. In addition to diabetes and fasting, ketosis can also occur during pregnancy and with prolonged breastfeeding. Usually, nausea and vomiting during pregnancy are related to the pregnancy itself, but sometimes it depends on other ailments. The connection of nausea and hyperemesis to pregnancy is not entirely clear. It is probably due to the increase in hormones, gonadotropin and estrogen. Gonadotropin CG is produced by the placenta at the beginning of the pregnancy period; estrogen is essential for carrying on with pregnancy. Estrogen levels are almost always very high in pregnant women suffering from hyperemesis gravidarum. In addition, progesterone also slows digestion, contributing to an increase in nausea and vomiting. Psychological triggers cannot be excluded. Vitamins along with iron can also cause nausea, and abnormal placental growth can cause vomiting. This growth is called the hydatiform mole. Once other conditions are ruled out, doctors can diagnose morning sickness and hyperemeresis gravidarum.
An alarm bell: disorders cannot be linked to pregnancy
However, nausea and vomiting can also depend on disorders not related to pregnancy, such as gastroenteritis, urinary tract infection or, more rarely, intestinal blockage. If a pregnant woman is vomiting, symptoms such as dehydration, dry mouth, rapid heartbeat, dizziness, poor urination and sweating, abdominal pain, fever, vomiting with streaks of blood, problems with vision and speech, confusion and weakness are troubling. they could also suggest a brain hemorrhage.In these cases, medical attention must be sought immediately. If the pregnant woman has moderate vomiting, does not lose weight and is not dehydrated, she may not even consult her doctor, unless the symptoms become too persistent. The doctor investigates the patient's medical history, if she has had pain, constipation, diarrhea, if she uses drugs that can induce vomiting, if she has also had this problem in other pregnancies, and then proceeds to a physical examination. This is to rule out signs of more serious disorders, such as too high or low blood pressure, fever, confusion, asthenia. The pelvic exam can prove the presence of a hydatiform mola, due to a defect in fertilization and other alterations. Pregnancy-dependent vomiting begins in the first three months, occurs for a few weeks, is not associated with abdominal pain or other intestinal problems. Nausea and vomiting are often also associated with increased salivation. If nausea and vomiting are mild there is no danger, not even for the fetus, but if the pregnant woman loses too much weight, she is no longer able to assimilate well the food ingested. These symptoms are also sometimes linked to psychological problems, caused by the new event, sometimes difficult to accept with serenity and without apprehension and to which the woman often feels unprepared, in addition to the fear of childbirth and the change in her body.
Analyzes, instrumental examinations, therapies and nutrition
If after 10 weeks of pregnancy the heartbeat of the fetus is not heard on the ultrasound examination, it may be a hydatiform mass. We proceed with urine tests to measure ketone levels and electrolyte levels and then with a pelvic ultrasound, in case abnormal growth of the placenta is considered possible. For vomiting, fluids are given intravenously; if it persists, vitamins, glucose and electrolytes are added in hospital. When vomiting stops, fluids can be taken orally and if the patient retains them, even small portions of food. Your doctor may prescribe safe non-fetal antiemetic medications or if needed doxylamine succinate and pyridoxine hydrochloride, active ingredients used together to reduce nausea and vomiting in pregnancy. Doxylamine is an antihistamine, pyridoxine hydrochloride is that vitamin B6.
If nausea and vomiting are related to pregnancy, the diet and lifestyle at the table can be changed. It is advisable to: eat little, but often (5 or 6 small meals a day), without being very hungry, eat only light foods, such as toast, apples, bananas, rice; a few biscuits in the morning before getting out of bed slowly, sitting for a while, drinking a lot during the day, but not sweet, cold or carbonated liquids; consuming foods low in fat and easy to digest to compensate for the nourishment lost through vomiting; being outdoors and in non-polluted environments; walking at a moderate pace and for short distances, sleeping with the window open at least in the warmer seasons; avoid smelling products that have strong and persistent odors. For nausea among the natural remedies we have tea or mint candies, foods and drinks with ginger, roots or licorice extract.
Chewable vitamins and car sickness patches can also be useful. If the drop in body weight and other symptoms do not disappear, feeding through a tube from the nose to the small intestine will be necessary. It may happen that the pregnant woman feels nausea for some foods such as coffee, tea, and fatty foods that she has always liked and instead feel the desire to eat foods that she has never liked; or he may feel nauseous just by smelling substances such as meat or alcohol.
