Morning Sickness: Cause, Symptoms and Treatment

Morning Sickness refers to nausea and vomiting which is experienced by women during pregnancy. Though, so called due to its belief that it occurs in the morning, there is in reality, no particular time of the day when the symptoms can arise.

It typically tends to occur in the first trimester (first three months) of pregnancy, however, many women may experience symptoms even throughout their pregnancy.

Causes of Morning Sickness

The exact cause behind this condition is unclear. It has been determined that the various hormonal and biochemical changes in the woman accompanying pregnancy are responsible.

Exposure to certain smells and foods can trigger the symptoms of nausea and vomiting.

Symptoms of Morning Sickness

• Nausea and uneasiness
• Vomiting
• Symptoms of Dehydration
  • Thirst
  • Dry mouth
  • Dizziness
  • Altered mental status

Diagnosis of Morning Sickness

There are no diagnostic tests required. This is a normal feature of most pregnancies and is managed symptomatically when mild. Monitoring for complications of severe dehydration is necessary to prevent harm to the mother and child.

Complications of Morning Sickness

When severe, the condition is referred to as hyperemesis gravidarum, which is characterized by severe bouts of vomiting with a loss of more than 5% of the individual’s body fluid. This also leads to the loss of electrolytes from the body. If persistent, hyperemesis gravidarum can lead to maternal weight loss and poor weight gain in the growing fetus.

If hyperemesis gravidarum is suspected, additional tests of urine is necessary.

Treatment of Morning Sickness

• The symptoms of nausea and vomiting may be prevented and controlled by
  • Avoiding food known to trigger the nausea
  • Eating small frequent meals to ensure the stomach does not become very full.
  • Vitamin B6 (Pyridoxine)
  • Doxylamine, available over the counter for nausea control
• Controlling the fluid and electrolyte imbalance
  • Increased fluid consumption
  • Intravenous fluids with inpatient admission may be necessary in hyperemesis gravidarum

References

1. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea and vomiting of pregnancy. Obstetrics & Gynecology, 2018;131:e15.
2. Vitamin B-6. Office of Dietary Supplements. Accessed Mar 20, 2019.
3. Refruezo JS, et al. Clinical features and evaluation of nausea and vomiting of pregnancy. https://www.uptodate.com/contents/search. Accessed Mar. 20, 2019.