Introduction
Morning sickness is a common symptom of pregnancy and is marked by nausea and occasional vomiting. Despite the name, morning sickness can cause discomfort at any time of the day, but it peaks in the early morning in most of the cases.
Morning sickness usually happens within the first four months of pregnancy and is often the first sign that a woman is pregnant.
Signs & symptoms
Nausea and vomiting especially in the morning
Loss of appetite
Tastelessness
Aversion to food
Gas trouble
Heartburn
Tiredness
Giddiness
Causes
The exact cause of morning sickness during pregnancy is unknown and severity varies among women. Increased hormone levels during the first few weeks of pregnancy are among the most common causes. Reduced levels of bold sugar can cause morning sickness.
Risk factors include:
- having twins or triplets
- Fatigue
- Emotional stress
- frequent traveling
Morning sickness can vary between pregnancies. While first pregnancy can be with severe morning sickness, in future pregnancies it may be very mild.
Pathophysiology
The pathophysiology of nausea and vomiting during early pregnancy is unknown, although metabolic, endocrine, gastrointestinal, and psychologic factors probably all play a role. Oestrogen may contribute because oestrogen levels are elevated in patients with hyperemesis gravidarum.
Urine tests
Urine tests to check for urinary infection or dehydration.
Blood chemistry tests
- Complete blood count (CTC)
- comprehensive metabolic panel
- comprehensive metabolic panel (Chem-20), to measure the electrolytes in your blood.
To determine
- dehydration
- malnourishment, or deficient in certain vitamins
- anaemia
Ultrasound
Ultrasound uses sound waves to produce images of the baby. These images and sounds are used to confirm baby is developing at a healthy rate.
Treatments
Supplements or medications to alleviate nausea can help retain foods and fluids. Medications include:
- Antihistamines: to help with nausea
- phenothiazine: to help calm severe nausea and vomiting
- metoclopramide (Reglan): to help the stomach move food into the intestines and help with nausea and vomiting
- antacids: to absorb stomach acid and help prevent acid reflux
Prognosis
Morning sickness — Nausea and vomiting often develop by five to six weeks of pregnancy. The symptoms are usually worst around nine weeks and typically improve by 16 to 18 weeks of pregnancy. However, symptoms continue into the third trimester in 15 to 20 percent of women and until delivery in 5 percent of women.
Complications
Mild morning sickness is common and not usually harmful. Nausea causes them to experience severe vomiting and weight loss in some women. It is known as hyperemesis gravidarum. It can lead to electrolyte imbalance and unintentional weight loss. If left untreated, this condition may eventually harm the foetus.
Emergency situations include signs and symptoms like:
- weight loss
- fever
- infrequent urination with small quantities of dark coloured urine
- light-headedness or dizziness
- palpitation
- severe nausea within the second trimester
- blood in the vomit
- frequent and severe headache
- abdominal pain
- spotting, or bleeding
Disease & Ayurveda
Garbhini chardi (morning sickness) is mentioned in Ayurveda as one of the vyaktagarbhalakshanas (confirmatory signs of pregnancy), not as a disease.
Nidana
Garbha-pregnancy
Purvaaroopa
Hrullasa-nausea
Samprapti
Not explained separately
Lakshana
Vomiting and nausea, especially in the morning time
Divisions
Not mentioned
Prognosis
Sadhyam
Chikithsa
Treatment of a pregnant woman is described as walking with a vessel full of oil in hand without spilling a drop of it. Utmost care and caution should be taken not to harm the baby or mother. In many cases, the vomiting subsides after the first trimester of pregnancy.
Samana
Vyadhivipareetachikithsa in needed cases only
Sodhana
No sodhana therapy should be done in pregnant woman until the completion of eighth month unless emergency.
Commonly used medicines
Laaja peya
Dasamoolam kashayam in severe conditions
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Taking the following steps may help prevent or minimize nausea:
- Drink plenty of water and liquid food items.
- Drink water before and after meals.
- Take naps.
- Ventilate the home and workspace.
- Avoid strong scents or nauseating smells
- Avoid spicy foods.
- Eat small meals in small intervals.
- Avoid fatty foods.
- Take vitamins and supplements if needed.
- Avoid cigarette smoke.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Juices, soups, and other kinds of liquid diets
Green gram, honey.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme hot and cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle.
Yoga
Regular stretching, meditation, nadeesuddhi pranayama and mild Yogic exercises are advised under medical supervision.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles