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Strategies to Treat Nausea & Vomiting During Pregnancy

According to published research, about 50% of women have nausea and vomiting in early pregnancy, and an additional 25% have nausea alone. The term “morning sickness” is a misnomer because it often persists throughout the day. In about 35% of women who have morning sickness, nausea and vomiting are clinically significant. As a result, family relationships may be negatively impacted or time may be lost at work. “Morning sickness symptoms may lead to dehydration and weight loss that require hospitalization in some cases,” says Jennifer R. Niebyl, MD, who described evidence-based strategies for managing nausea and vomiting in pregnant women in a review published in the October 14, 2010 New England Journal of Medicine. “Nausea and vomiting in pregnancy can severely reduce quality of life for women, but progress has been made in the means to treat it,” says Dr. Niebyl. “Pregnant women with dehydration are recommended to receive IV fluid replacement with multivitamins, especially thiamine. If the vomiting continues after 12 hours of IV therapy, hospitalization may be required.” Enteral or parenteral nutrition may also benefit patients, but should be reserved for those who continue to experience weight loss despite pharmacologic therapies. Examining the Clinical Course The cause of nausea and vomiting in pregnancy is unclear, and there are no evidence-based means to identify women who are risk for this complication. What is known, however, is that the onset of the nausea is typically within 4 weeks after the last menstrual period in most patients. The problem typically peaks at about 9 weeks gestation. “Research shows that about 60% of cases resolve by the end of the first trimester,...
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