NAUSEA and vomiting are fairly common in pregnancy. These symptoms usually resolve before five months of pregnancy. It affects about nine in 10 pregnancies and is considered normal.
It usually starts at about the fourth to seventh week, but gets better by the 14th week. It usually does not affect the health of your baby.
However, if the nausea and vomiting is severe that it causes a change in your mood, work, home or social life than it is not normal. It is classified as hyperemesis gravidarum. It occurs in about three in 100 pregnant women.
The cause of these nausea and vomiting is the increased hormone levels during pregnancy. The main hormone causing these symptoms is GDF-15 that is produced by the baby’s placenta.
It also has some genetic influence. Your risk of it happening increases if you are pregnant with more than one baby or if you have had it in your previous pregnancy.
In severe cases, you are unable to keep any food or drinks down as everything comes out. You become dehydrated that you are unable to function normally.
Signs of dehydration include:
Feeling dry
Very thirsty
Becoming drowsy
Being unwell
Having weakness
Urine changing to dark yellow or brownish in colour
You also need to make sure your symptoms are not due to other diseases. This is especially important if you have other symptoms such as pain or increased frequency in urination, pain in your tummy, other medical problems or vomiting after 16 weeks of pregnancy.
Change of lifestyle
The easiest way to overcome the problem is to change your lifestyle temporarily during this period. The first thing you should do is have frequent but small meals – that way your stomach does not expand too much and you end up vomiting. Next is to stay hydrated.
Always drink small amounts of water frequently.
If you have been vomiting for some time, you may feel some weakness in your muscles. This could mean you are lacking some salts in your body. The most natural isotonic drink that can help you is fresh coconut water. Other remedies recommended include rice water, lime juice, isotonic drinks and the local favourite asam boi.
If your condition escalates, please see your doctor. They would assess and advise based on your condition– and usually, you can be treated on an outpatient basis. Mostly, your doctor may prescribe you medication that would stop you from vomiting.
This would help reverse your condition back to normal, so you recover on your own. In some severe cases that seriously affects your health, you are usually advised to get admitted to a hospital.
The first line of treatment would be to start you on intravenous fluid. Depending on the severity of your dehydration, the drip may be run fast to catch up with your losses.
Based on your blood tests, the salt content on your body as well as the acidity of your blood will determine what else needs to be added into your drip to hasten your recovery.
The vomiting is also required to be stopped. If you are unable to take anything orally, the medication to stop vomiting may have to be given intravenously. Your blood and urine will be regularly monitored to ensure that you are in the recovery phase or your treatment will be adjusted. In most cases, this should resolve in less than three days and you should be able to go home.
This article is contributed by consultant obstetrician & gynaecologist, maternal fetal medicine Datuk Dr H. Krishna Kumar.
