Nausea and vomiting are very common symptoms in early pregnancy.

Although this is often referred to as “morning sickness”, it can occur at any time of the day and night.

They affect up to 90% of pregnant women, to varying degrees. It may be occasional mild nausea, nausea accompanied by vomiting, or even intense and persistent vomiting, leading to dehydration (this is called hyperemesis gravidarum). Hyperemesis gravidarum affects approximately 1 to 2% of pregnant women.

These unpleasant symptoms usually appear around 4 weeks gestation (6 weeks gestation), but can occur early on or later. The peak is usually reached between 7 and 12 weeks of pregnancy and the symptoms go away naturally, in the vast majority of cases, before the 16th^st week.

However, some pregnant women may experience nausea and vomiting beyond 20 weeks of pregnancy, and even until childbirth.

The causes are not very well known and are probably multifactorial. Several hypotheses have been put forward, in particular:

• a very rapid increase in hormone levels, especially Beta-hCG
• a dysfunction of the digestive system linked to the effect of estrogen
• psychological causes (anxiety, various fears, etc.)
• genetic predisposition

Even when mild, nausea and vomiting are painful. They add to the fatigue of the first trimester and can cause significant discomfort, impair daily life, increase absenteeism from work and interfere with interpersonal relationships.

They can be a real source of distress and should therefore be taken seriously.

In the case of hyperemesis gravidarum, which affects up to 2% of pregnant women, the consequences are potentially serious and hospitalization is usually necessary. Intense vomiting leads to weight loss (more than 5% of the total weight), dehydration, electrolyte imbalance and ketonuria (abnormal presence of certain compounds in the urine).

Hyperemesis gravidarum is also associated with an increased risk of premature birth and low birth weight.

There is no quick fix for nausea during pregnancy. Several tips can help mitigate them, including:

• rest (nausea is made worse by fatigue)
• split meals (eat often, in small amounts, do not have an empty stomach)
• eat a dry cookie in the morning when you wake up, before getting up
• drink enough
• avoid strong tasting, spicy foods, strong smells and favor starchy foods, bread and foods that make you want!

Several studies have shown that ginger can be effective, either in the form of herbal tea, or “fresh” to chew, or in the form of tablets. The pharmacist can advise you on the products available. However, it is advisable not to take too large doses of ginger, because studies have not shown its safety beyond 1000 mg per day.

Acupuncture and acupressure bracelets (point on the wrist) can provide relief for some women.

If the vomiting is really debilitating, certain antiemetic drugs may be prescribed by the doctor (based on alizapride, domperidone, metoclopramide, metopimazine in particular). In Quebec, Diclectin (a doxylamine / pyridoxine combination) is frequently prescribed.

In the event of weight loss and persistent vomiting, hospitalization may be necessary to prevent serious complications.