Vomiting in Preganacy
Vomiting is a common and debilitating symptom in the early months of pregnancy. In fact it is so common in pregnancy, that in many primitive societies nausea and vomiting in a young or newly married is considered a sign of pregnancy.
Causes of Vomiting of pregnancy
Though the exact cause of vomiting in pregnancy is not known, it is believed to be caused by a complex interaction between hormonal, psychological and immunological factors. Pregnancy is a time of great hormonal changes, there is a high level of progesterone in the blood. It may cause its effects by acting on those parts of brain responsible for vomiting. It also causes relaxation of the gastrointestinal tract and all sphincters. This could be another reason for vomiting.
Pregnancy is also a time for immunological changes because of the foreign antigens in body (the baby if foreign to the mother’s body). To keep the body’s immune system from attacking the growing baby, many inhibitors of the immune system develop. These also cause vomiting.
Psychological factors play a very important role in vomiting of pregnancy. Excess vomiting is usually seen in states of psychological stress like separation, fights, etc. Many times vomiting in pregnancy is controlled simply by a change of place or environment.
Excess vomiting in pregnancy is usually associated with twin pregnancies. It is also associated with polyhydramnios( A condition where there is too much amniotic fluid)
General features
Vomiting usually starts by 3-4 weeks of pregnancy and continue till 18-20 weeks of pregnancy. However in a few women it may be present throughout the pregnancy. Typically it is present in the form of nausea and few bouts of bilious vomiting (Vomits is yellow to green in colour) in the hours after awakening. It is also associated with altered taste and smell.
In fact the alteration of smell is so predominant that women may find certain odour to be extremely nauseating. Some of the common odours women find nauseating include fried oil, cigarette smoke, alcohol and many more depending on subjective prejudices of women. Some women may find their husbands nauseating because of their odour.
Excess Vomiting of Pregnancy
Although vomiting in pregnancy is very common, excessive vomiting is dangerous to the health of the mother and child. Excess vomiting will cause dehydration and keto-acidosis in mothers and may cause abortion and premature births.
A useful bench mark to determine severity of the vomiting is to assess it in relation to food intake. Normal vomiting of pregnancy rarely interferes with eating. Although women develop altered taste it does not affect their appetite. However in excess vomiting appetite goes down.
Some of the signs and symptoms of excess vomiting are weight loss, loos of appetite, sunken eyes, fast heart rate, and fever. Etc.
Treatment & Summary
Initial management of excess vomiting in pregnancy consists of general measures like reassurance, admission and observation. The lady must be kept in an comfortable surroundings and she should not be disturbed. She should ensure intake of sufficient fluids. Women with excess vomiting must also receive vitamin supplements. Pyridoxine, one of the Vit B complex is proven to be effective for vomiting of pregnancy. It is generally taken one tab twice a day for as long as vomiting persists. This medicine has not been shown to have any adverse effects on the baby. So you can have as long as it benefits you.
There are many other medicines available for treatment of excess vomiting of pregnancy; however you should try them only under the supervision of your doctor.
Excess vomiting of pregnancy is generally controlled by these measures, but some women may require admission and intravenous fluids and their vomiting was not under control.To sum up Vomiting in pregnancy is common and manageable. However care must be taken that excess vomiting of pregnancy does not harm the life of mother and baby. Early recognition of excess vomiting of pregnancy is essential to institute treatment. This will go a long way in ensuring a good maternal and foetal outcome.