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These ailments appear in the first trimester of pregnancy. As a rule, they occur in the morning, they are more troublesome for women in their first pregnancy.
The direct cause of nausea and vomiting in pregnant women is still unknown. Fortunately, they usually do not have the serious consequences of maternal electrolyte disturbances and can be managed conservatively at home. Relief is provided by a proper, easily digestible diet, meals often eaten in small amounts, with the separation of food and drink. Rest, calm and relaxation are also beneficial.
If possible, medications other than vitamins C and B6 should not be used in very early pregnancy. The case is different in the case of the so-called irresistible vomiting of pregnant women (hyperemesis gravidarum). They occur relatively rarely, as only 0,1% of pregnant women. However, their ramifications are so serious that they cannot be ignored. Due to dehydration, uninterrupted results lead to water and electrolyte disturbances, weight loss, and multiorgan complications, including damage to the liver, brain and kidneys. The cause of unrestrained vomiting of pregnant women is still not fully understood. It is presumed that this condition is associated with high levels of beta HCG and progesterone (which would explain the greater severity and frequency of these ailments in women with multiple pregnancies), as well as with hyperthyroidism and adrenal insufficiency. Many observations show that the woman’s psychological sphere also plays a significant role in the etiology of this pregnancy complication. Patients who became pregnant by accident, did not plan pregnancy, or conceived a child with an unloved partner, more often report various ailments, especially vomiting.
Unstoppable vomiting requires absolute hospitalization and treatment. In the first stage, the therapy consists in administering physiological fluids in amounts that cover the daily demand for water and electrolytes, and for glucose, which is the basic energy material. Subsequently, vitamin deficiencies are supplemented – mainly from group B, as well as other nutritional deficiencies. Gradually, an easily digestible diet is introduced and extended slowly. In exceptional circumstances, in the absence of response to the treatment described above, full parenteral nutrition may be necessary. Fortunately, this happens extremely rarely. As a rule, after a few to several days in hospital, the patient can return home with recommendations on a sparing lifestyle, on an easily digestible diet, taking vitamins – especially from the B group.
It should be remembered that in the first trimester of pregnancy, all medications, except folic acid, are contraindicated and, unless otherwise prescribed by the doctor, should be avoided. Antiemetics are potentially teratogenic, so they should be used with caution and only when absolutely necessary.
Text: lek. med. Ewa Zarudzka