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Michael P. Carson, M.D., is an Obstetric Internist and Director of Obstetric Medicine for the Comprehensive Care Group in New Brunswick, NJ, as well as Chief of the Division of General Internal Medicine at St. Peter's University Hospital. He is also an Assistant Clinical Professor of Medicine and an Assistant Clinical Professor of Obstetrics, Gynecology & Reproductive Sciences at UMDNJ's Robert Wood Johnson Medical School. Dr. Carson is board certified in internal medicine and graduated from Temple University School of Medicine. His training in Internal Medicine and his fellowship in Obstetric Medicine were both at Brown University School of Medicine. For more information on Dr. Carson, please visit http://tinyurl.com/michaelcarsonmd.

Nausea & Vomiting in Pregnancy

How common are nausea and vomiting in pregnancy?

Nausea and vomiting are very common symptoms in pregnancy, affecting about 50% of pregnant women. It can vary from morning sickness (mild nausea and/or vomiting), to heartburn/gastro-esophageal reflux, to hyperemesis gravidarum.

What is Hyperemesis Gravidarum?

Hyperemesis gravidarum is severe nausea and vomiting that occurs in 0.1%--1% of pregnancies. It always occurs in the first trimester (months 1 to 3) and is characterized by severe vomiting that may lead to dehydration. The exact cause is not clear, but it is thought to be related to hormonal changes that occur in your body during a normal pregnancy. Many women also experience heartburn and something called ptyalism, an inability to swallow their saliva.

Why is my doctor concerned about my vomiting?

Persistent vomiting can lead to dehydration, weight loss, electrolyte imbalances, and esophagus or stomach inflammation. Prevention of these complications will keep the mother healthy so the fetus will have the best possible conditions in which to develop.

How is this treated?

It depends on the severity and what you decide with your doctors. The goal is to decrease the awful problem of vomiting, keep you out of the hospital, and help you to keep up with the responsibilities of your family and professional lives. The evaluation may include meeting with a medical specialist, a dietician, a psychologist, and lab studies. Treatments vary from simple (elevating the head of your bed to decrease acid reflux, diet modification), to recommending medications (to decrease nausea or acid reflux). While some women require home intravenous fluids, most treatments are temporary because this problem improves after the third month. Women whose symptoms continue beyond the third month usually have acid reflux that will respond to the simple treatments listed above.

Can this affect my fetus?

A healthy fetus requires a healthy mother. Severe dehydration, poor nutrition, and electrolyte abnormalities are what we want to avoid. We are aware that the idea of using medications during pregnancy concerns many women. Your doctor will discuss these issues with you and recommend medications that offer the most benefit with the lowest possible risk.

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Created: 1/10/2001  -  Michael P. Carson, M.D.

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