When Morning Sickness Hits

When Morning Sickness Hits

An expert explains the nausea that often goes with pregnancy

Up to 70 percent of pregnant women suffer nausea from morning sickness, and not always in the morning. Dr. Donald Coustan, Chairman of the Obstetrics and Gynecology Department at Brown University School of Medicine, advises how to relieve the discomfort.

What is morning sickness and what are its symptoms?

Morning sickness is nausea, with and without vomiting, during pregnancy. It may occur at any time of day, especially when the stomach is empty. While it is most common during the first three months of pregnancy, it may continue beyond that time and may recur toward the end of pregnancy. But the problem usually goes away by 13 to 20 weeks of gestation.

What causes morning sickness?

It is not well understood, but many doctors believe that hormonal changes may be involved. Women prone to morning sickness often report that particular odors, sights, or tastes may trigger an episode.

Are some more susceptible than others?

Yes, although one study estimated that nausea and vomiting occur in up to 70 percent of pregnancies.

What treatment is recommended?

We usually recommend that women prone to morning sickness eat five or six small meals each day in order to avoid an empty stomach as much as possible. Some women are helped by eating dry soda crackers, a peeled apple or a plain potato (peeled and cooked). They are also advised to avoid unpleasant odors and folds that trigger an attack. Women who experience nausea and vomiting so severe that they cannot even keep down frequent small meals, and whose urinary output fails, should consult their obstetrician. In such cases, it may be necessary to provide intravenous fluids and injections of medications to break the cycle and treat dehydration. Otherwise, there could be liver or kidney damage to the mother and even starvation.

A couple of nice girls. Photo by Elena

Are there any drugs that can help?

No. There previously was a medication known as Bendectin, which consisted of vitamin B6 and doxylamine, an antihistamine, which appeared to be effective. It was removed from the market, however, because of lawsuits alleging that it caused birth defects. Although it was never demonstrated that the medication caused birth defects, and most of the lawsuits were won by the defense, the company spent so much money defending the suits that they were unable to continue making the drug. The components of this drug may be useful, but they are not as well-studied as the combination.

Keeping Your Baby from Harm's Way

Beware of what these agents could do to the fetus

Agent, Reasons used, effects.

Alcohol – Part of regular diet, social reasons, dependency – Growth and mental retardation.

Androgens – To treat endometriosis – Genital abnormalities.

Anticoagulants – Warfarin (Coumadin, Panwarfin) and dicumatrol – To prevent blood clotting; used to prevent or treat thromboembolisms (clots blocking blood vessels). Abnormalities in bones, cartilage and eyes; central nervuos system defects.

Antithyroid drugs - Propylthiouracil, iodide, methimazole (tapazole) – To treat an overactive thyroid gland – Underactive or enlarged thyroid.

Anticonvulsants – Phentoin (Dilantin), trimethadione (Tridione), paramethadione (Paradione), valproic acid (Depakene) – To treat epilepsy and irregular heartbeat – Growth and mental retardation, developmental abnormalities, neural tube defects.

Chemotherapeutic drugs – Methotrexate (Mexate) and aminopterin – To treat cancer and psoriasis – Increased rate of miscarriage, varios abnormalities.

Diethylsibestrol (DES) – To treat problems with menstruation, syptoms of menapause and breast cancer, and to stop milk production; previously used to prevent preterm labor and miscarriage – Abnormalities of cevix and uterus in females, possible infertility in males and females.

Lead – Industries involving lead smelting, paint manufacture and use, printing, ceramics, glass manufacturing, and pottery glazing – Increased rate of miscarriage and stillbirths.

Lithium – To treat the manic part of manic-depressive disorders. - Congenital heart disease.

Organic mercury – Exposure through eating contaminated food. - Brian disorders.

Isotretinoin (accutane) – Treatment for cystic acne – Increased rate of miscarriage, developmental abnormalities.

Streptomycin – An antibiotic used to treat tuberculosis – Hearing loss.

Tetracyclin – An antibiotic used to treat a wide variety of infections – Underdevelopment of tooth enamel, incorporation of tetracycline into bone.

Thalidomide – Previously used as a sedative and a sleep aid – Growth deficiencies, other abnormalities.

X-Ray therapy – Medical treatment of disorders such as cancer – Growth and mental retardation.