Morning sickness

nausea due to pregnancy
not to be confused with mourning illness medical condition
Morning sickness, besides called nausea and vomiting of pregnancy ( NVP ), is a symptom of pregnancy that involves nausea or vomit. [ 1 ] Despite the mention, nausea or vomit can occur at any time during the day. [ 2 ] typically the symptoms occur between the 4th and 16th workweek of pregnancy. [ 2 ] About 10 % of women however have symptoms after the twentieth workweek of pregnancy. [ 2 ] A severe form of the condition is known as hyperemesis gravidarum and results in weight loss. [ 1 ] [ 6 ]

Reading: Morning sickness

The cause of morning sickness is obscure but may relate to changing levels of the hormone human chorionic gonadotropin. [ 2 ] Some have proposed that morning illness may be utilitarian 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 dawn illness. [ 1 ] Taking prenatal vitamins before pregnancy may decrease the risk. [ 3 ] Specific treatment other than a bland diet may not be required for meek cases. [ 2 ] [ 6 ] [ 3 ] If treatment is used the combination of doxylamine and vitamin b6 is recommended initially. [ 3 ] [ 4 ] There is limited evidence that ginger may be utilitarian. [ 3 ] [ 7 ] For severe cases that have not improved with other measures methylprednisolone may be tried. [ 3 ] Tube eating may be required in women who are losing slant. [ 3 ] Morning illness affects about 70–80 % of all meaning 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 meaning, and solution in health-care expenses. [ 3 ] Generally, balmy to moderate cases have no effect on the fetus, and most severe cases besides have convention outcomes. [ 1 ] Some women choose to have an miscarriage due to the badness of symptoms. [ 1 ] Complications such as Wernicke brain disorder or esophageal rupture may occur, but identical rarely. [ 1 ]

Signs and symptoms [edit ]

about 66 % of women have both nausea and vomiting while 33 % have equitable nausea. [ 1 ]

cause [edit ]

The campaign of dawn sickness is unknown but may relate to changing levels of estrogen and the hormone human chorionic gonadotropin. [ 2 ] [ 8 ] Some have proposed that good morning nausea may be useful from an evolutionary bespeak of view, arguing that good morning sickness may protect both the pregnant charwoman and the develop embryo barely when the fetus is most vulnerable. [ 1 ] Diagnosis should only occur after early possible causes have been ruled out. [ 3 ] Abdominal trouble, fever, or headaches are typically not present in morning sickness. [ 1 ] nausea and vomit may besides occur with molar pregnancy. [ 9 ] Morning illness is related to diets low in cereals and gamey in sugars, oilcrops, alcohol and kernel. [ 10 ]

Pathophysiology [edit ]

hormone changes [edit ]

Pathophysiology of vomiting in pregnancy

defense mechanism [edit ]

Morning nausea may be an develop trait that protects the fetus against toxins ingested by the mother. evidence in support of this theory includes : [ 14 ] [ 15 ]

  • Morning sickness is very common among pregnant women, which argues in favor of its being a functional adaptation and against the idea that it is a pathology.
  • Fetal vulnerability to toxins peaks at around 3 months, which is also the time of peak susceptibility to morning sickness.
  • There is a good correlation between toxin concentrations in foods, and the tastes and odors that cause revulsion.

Women who have no morning nausea are more probably to miscarry. [ 16 ] This may be because such women are more probably to ingest substances that are harmful to the fetus. [ 17 ]

In accession to protecting the fetus, dawn sickness may besides protect the mother. A pregnant womanhood ‘s immune system is suppressed during pregnancy, presumably to reduce the chances of rejecting tissues of her own offspring. [ 18 ] Because of this, animal products containing parasites and harmful bacteria can be particularly dangerous to meaning women. There is testify that dawn sickness is often triggered by animal products including kernel and fish. [ 19 ] If dawn sickness is a defense mechanism against the consumption of toxins, the order of anti-nausea medicine to meaning women may have the undesired side impression of causing birth defects or miscarriages by encouraging harmful dietary choices. [ 14 ] besides dawn sickness is a defense mechanism because when analyzing embryonic growth, several critical periods are identified in which there is mass proliferation and cell division resulting in the development of the heart and cardinal skittish system that are very sensitive. In that period, the fetus is most at risk from wrong to toxins and mutagens. These developments occur through week 6-18 which is in the same time frame in which the most nausea and vomit of pregnancy ( NVP ) occurs. This kinship between the clock time at which the embryo is most susceptible to toxins lines up precisely with when the most dangerous NVP symptoms are seen, suggesting that this NVP is an evolutionary reaction developed in the mother, to indicate the sensitivity of the fetus therefore making her wary to her health and in turn protecting the fetus. [ 20 ]

Treatments [edit ]

There is a miss of adept testify to support the consumption of any particular intervention for good morning illness. [ 21 ]

Medications [edit ]

A number of antiemetics are effective and safe in pregnancy including : pyridoxine/doxylamine, antihistamines ( such as diphenhydramine ), metoclopramide, and phenothiazines ( such as promethazine ). [ 22 ] [ 23 ] With respect to effectiveness it is strange if one is superior to another. [ 22 ] In the United States and Canada, the doxylamine-pyridoxine combination ( as Diclegis in US and Diclectin in Canada ) is the only approved pregnancy class “ A ” prescription treatment for nausea and vomit of pregnancy. [ 23 ] Ondansetron may be beneficial, but there are some concerns regarding an association with cleave palate, [ 24 ] and there is little high quality data. [ 22 ] Metoclopramide is besides used and relatively well tolerated. [ 25 ] evidence for the use of corticosteroids is weak. [ 26 ]

alternate medicine [edit ]

Some studies support the use of pep, but overall the evidence is limited and discrepant. [ 3 ] [ 7 ] [ 21 ] [ 27 ] [ 8 ] Safety concerns have been raised regarding its anticoagulant properties. [ 28 ] [ 29 ] [ 8 ] [ 30 ]

history [edit ]

thalidomide [edit ]

Thalidomide was in the first place developed and prescribed as a bring around for good morning sickness in West Germany, but its consumption was discontinued when it was found to cause birth defects. [ 31 ] The United States Food and Drug Administration never approved thalidomide for function as a cure for dawn sickness. [ 32 ]

References [edit ]

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