Morning sickness

Not to be confused with Mourning sickness.
Morning sickness
Other namesNausea and vomiting of pregnancy, nausea gravidarum, emesis gravidarum, pregnancy sickness
SpecialtyObstetrics
SymptomsNausea, vomiting[1]
ComplicationsWernicke encephalopathy, esophageal rupture[1]
Usual onset4th week of pregnancy[2]
DurationUntil 16th week of pregnancy[2]
CausesUnknown[2]
Diagnostic methodBased on symptoms after other causes have been ruled out[3]
Differential diagnosisHyperemesis gravidarum[1]
PreventionPrenatal vitamins[3]
TreatmentDoxylamine and pyridoxine[3][4]
Frequency~75% of pregnancies[4][5]

Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting.[1] Despite the name, nausea or vomiting can occur at any time during the day.[2] Typically the symptoms occur between the 4th and 16th week of pregnancy.[2] About 10% of women still have symptoms after the 20th week of pregnancy.[2] A severe form of the condition is known as hyperemesis gravidarum and results in weight loss.[1][6]

The cause of morning sickness is unknown but may relate to changing levels of the hormone human chorionic gonadotropin.[2] Some have proposed that morning sickness may be useful from an evolutionary point of view.[1] Diagnosis should only occur after other possible causes have been ruled out.[3] Abdominal pain, fever, or headaches are typically not present in morning sickness.[1]

Taking prenatal vitamins before pregnancy may decrease the risk.[3] Specific treatment other than a bland diet may not be required for mild cases.[2][6][3] If treatment is used the combination of doxylamine and pyridoxine is recommended initially.[3][4] There is limited evidence that ginger may be useful.[3][7] For severe cases that have not improved with other measures methylprednisolone may be tried.[3] Tube feeding may be required in women who are losing weight.[3]

Morning sickness affects about 70–80% of all pregnant women to some extent.[4][5] About 60% of women experience vomiting.[2] Hyperemesis gravidarum occurs in about 1.6% of pregnancies.[1] Morning sickness can negatively affect quality of life, result in decreased ability to work while pregnant, and result in health-care expenses.[3] Generally, mild to moderate cases have no effect on the fetus, and most severe cases also have normal outcomes.[1] Some women choose to have an abortion due to the severity of symptoms.[1] Complications such as Wernicke encephalopathy or esophageal rupture may occur, but very rarely.[1]

  1. ^ a b c d e f g h i j k "Practice Bulletin No. 153: Nausea and Vomiting of Pregnancy". Obstetrics and Gynecology. 126 (3): e12–e24. September 2015. doi:10.1097/AOG.0000000000001048. PMID 26287788. S2CID 19552518.
  2. ^ a b c d e f g h i Festin M (June 2009). "Nausea and vomiting in early pregnancy". BMJ Clinical Evidence. 2009. PMC 2907767. PMID 21726485.
  3. ^ a b c d e f g h i j k "Practice Bulletin Summary No. 153: Nausea and Vomiting of Pregnancy". Obstetrics and Gynecology (Review). 126 (3): 687–688. September 2015. doi:10.1097/01.aog.0000471177.80067.19. PMID 26287781. S2CID 39256123.
  4. ^ a b c d Koren G (December 2014). "Treating morning sickness in the United States--changes in prescribing are needed". American Journal of Obstetrics and Gynecology. 211 (6): 602–606. doi:10.1016/j.ajog.2014.08.017. PMID 25151184.
  5. ^ a b Einarson TR, Piwko C, Koren G (2013-01-01). "Prevalence of nausea and vomiting of pregnancy in the USA: a meta analysis". Journal of Population Therapeutics and Clinical Pharmacology. 20 (2): e163–e170. PMID 23863545.
  6. ^ a b "Pregnancy". Office on Women's Health. September 27, 2010. Archived from the original on 10 December 2015. Retrieved 5 December 2015.
  7. ^ Cite error: The named reference ReferenceB was invoked but never defined (see the help page).