Morning Sickness

Overview

Pregnancy, in most cases, is accompanied by associated clinical complications which normally stop after delivery. The most troublesome condition experienced by women in the prenatal stage is “Morning Sickness”. According to reports by the World Health Organization, nearly two-thirds of all pregnant women experience mild to severe morning sickness after 6-7 weeks of pregnancy. Although morning sickness is not considered as some disease, a doctor must be consulted in order to alleviate extreme conditions affecting the health of the mother.

What is morning sickness?

Morning sickness refers to the group of symptoms such as nausea, vomiting, headache, loss of appetite etc that are manifested during the pregnancy period due to hormonal fluctuations and associated clinical factors like neurological, psychosomatic and metabolic changes. The symptoms are more prominent during the first three months of pregnancy. Extreme cases of morning sickness are termed as “hyperemesis gravidarum”. These symptoms are controllable via proper diet and therapeutic measures. Sometimes the term “morning sickness” is a misnomer because similar symptoms may occur during other times of the day as well (mainly at night). In most cases, morning sickness symptoms last until the fourth month of pregnancy.

What causes morning sickness?

The exact etiological factors behind morning sickness are still under research. But research workers and health organizations have identified few factors that contribute to morning sickness. These are listed below-

• Hormonal changes, especially high levels of estrogen and the Human Chorionic Gonadotrophin (HCG)
• Extreme sensitivity to odors which stimulates the gastrointestinal tract and triggers a gag reflex (causes vomiting)
• Frequent variations in blood pressure (mostly low blood pressure conditions)
• Fluctuations in blood sugar levels (low blood sugar conditions)
• Metabolic changes, particularly a marked change in carbohydrate metabolism
• Past intake of birth control pills
• A family history of morning sickness
• Existing or past motion sickness or migraine conditions
• Intake of a diet deficient in essential nutrients (before conception)
• Intake of prenatal medicines containing an excessive amount of iron ( causes nausea and vomiting)
• Pregnancy with twins or female fetus
• Morning sickness symptoms in past pregnancy
• Existing pathological conditions like thyroid gland problems, gallbladder disease or ulcers
• Stress related to pregnancy

Symptoms of morning sickness

The symptoms of morning sickness start manifesting themselves within or shortly after the 4^th or 6^th week of pregnancy. The most common symptoms are as follows-

• Extreme nausea and vomiting
• Blood in vomit
• Difficulty passing urine and occasional burning sensation
• Passing a very weak stream of dark colored urine
• Rapid heart rate
• Profuse sweating
• Dehydration due to inability to retain fluids
• Dizziness and lightheadedness
• Extreme fatigue and sluggishness
• Abnormal loss of appetite and repulsion towards food
• Mental instability, anxiety, and depression
• Temporary disturbance of memory (in rare cases)
• Loss of body weight (by about 5%)
• Dryness within mouth and throat
• Gastrointestinal disorders like diarrhea, constipation
• A feeling of abnormally heavy sensation in the uterus
• Belching
• Bitter taste in mouth after drinking water
• Motion sickness
• An extreme headache
• Heartburn
• Discomfort around chest
• Occasional breathlessness
• Disturbed sleep (sleep apnea, insomnia)

If the symptoms continue for a prolonged period and become serious, a doctor must be consulted.

Complications of morning sickness

Morning sickness can persist for a long time and lead to serious complications within the body of both the mother and the child. The following complications are normally observed when hyperemesis gravidarum is left untreated-

• Malnutrition and deficiency of the fetus (due to insufficient retention of nutrients within the body in case of extreme vomiting)
• Electrolyte imbalance within the mother’s body ( mainly due to drop in sodium level)
• Extreme stress on vital organs such as the heart, lungs, liver, and kidneys
• Miscarriage may occur in few extreme cases
• Sudden palpitations may lead to chronic cardiovascular disorders

Effect of morning sickness on baby

Many women consider morning sickness as a sign of serious illness or complications related to pregnancy and worry that it might affect the health of the child. But according to doctors morning sickness (up to a certain extent) is a very healthy sign and indicates that the placental connection between the mother and the fetus is working fine.

Recommendations for morning sickness

Morning sickness can be controlled by adhering to a few dietary rules along with other recommendations by physicians. These are as follows-

• Avoid oily or greasy food
• Stay away from odors that might evoke nausea
• Have small meals at regular intervals of time
• Drink lots of fluids (especially between consecutive meals)
• Take Vitamin B6 supplements in amounts recommended by the doctor
• Wear loose-fitting clothes for proper ventilation
• Avoid active and passive smoking or consumption of alcohol
• Avoid strong stimulants like tea or coffee
• Avoid canned foods, raw and uncooked vegetables, unripe fruits and excess salt
• Have low protein foods ( eggs, boiled beans, lean meat) and carbohydrates ( baked potato, white rice, fruits, cereals)
• Have sour or salty food (helps reduce nausea)
• Try acupuncture and acupressure techniques ( facilitates relaxation )
• Get extra hours of sleep
• Have bedtime snacks and early morning snacks
• Avoid iron tablets
• Inhale fresh air as much as possible
• Avoid quick and jerky movements
• While lying down, support your head and feet with pillows

Diagnosis of morning sickness

For accurate diagnosis of morning sickness, ultrasonography must be carried out from time to time to examine the health conditions of both mother and fetus. In case of severe and long-lasting complications, blood tests are recommended to determine the cause of morning sickness.

Managing the symptoms

Morning sickness doesn’t usually require any specific treatment measures. The following steps can help in managing the symptoms and also decreasing the frequency of morning sickness bouts:

• Get ample of rest.
• Have regular fluid intake. Instead of chugging down volumes of water, take liquids in small quantities and in regular intervals.
• Suck on ice chips or candies to prevent recurrent nausea.
• Avoid sweet and spicy foods. Instead, eat plain crackers. Also, eat more cold foods.
• Identify what all exactly trigger your morning sickness (strong odors, high temperature, pungent foods etc) and steer clear of them.
• Certain medications (anti-emetics) might be prescribed in case the morning sickness symptoms become worse.

References