nausea%20-and-%20vomiting%20in%20pregnancy
NAUSEA & VOMITING IN PREGNANCY
Nausea & vomiting in pregnancy (NVP), commonly known as "morning sickness", affects 50-90% of pregnant women.
In most women, the condition manifests between the 4th-7th week after last menstrual period and resolves by the 16th week of gestation.
It manifests in a spectrum of severity from mild nausea to very rare life-threatening symptoms.
The etiology is multifactorial.
The pregnant woman's sense of well-being and her daily activities are greatly affected by nausea and vomiting; the physical and emotional impact often leads to anxiety and worry about the effect of the symptoms on the fetus and reduced job efficiency.

Supportive Therapy

Consider inpatient treatment for pregnant patients with the following:

  • Persistently abnormal vital signs
  • Severe dehydration unable to tolerate oral fluids
  • Severe electrolyte abnormality and acidosis
  • Malnutrition
  • Presence of infection and unable to tolerate oral antibiotics
  • Inability to take oral antiemetics

Supportive Measures

Rehydration

  • Warranted when dehydration, electrolyte abnormalities, or acid-base disturbances are demonstrated
  • Intravenous (IV) Fluids
    • Normal saline or Ringer’s lactate, maintain urine output to >100 mL/hour
    • Urea and serum electrolyte levels should be monitored while on IV fluids
  • Correction of electrolyte imbalance including magnesium, calcium, potassium, and phosphorus
  • Multivitamin IV supplementation especially thiamine to prevent Wernicke’s encephalopathy

Enteral (EN) or Parenteral Nutrition (PN)

  • As a last resort measure and monitored in centers with the ability to provide home parenteral therapy
  • Indicated for patients with persistent weight loss despite use of noninvasive therapies
  • EN should be initiated as a slow, continuous, isotonic infusion
  • PN is used when EN is not tolerated
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, Yesterday

Individuals with moderate-to-severe plaque psoriasis may reap better long-term improvements in the severity of their condition when treated with guselkumab over secukinumab, according to findings of the phase III ECLIPSE* trial presented at the recent Inflammatory Skin Disease Summit (ISDS 2018) held in Vienna, Austria.

Jairia Dela Cruz, 11 Jan 2019
Use of standard-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) appears to confer protection against the risk of endometrial cancer in overweight and obese women, according to a meta-analysis.
Elvira Manzano, 2 days ago
Treatment with two investigational, oral JAK inhibitors may be beneficial in individuals with moderate‐to‐severe alopecia areata (spot baldness), an autoimmune disease that can cause a lot of anxiety, according to an ongoing phase II study.
Yesterday
There appears to be no clear link between pornography use, even at problematic levels, and erectile dysfunction, a recent US study has shown.