Nausea and vomiting are both common in early pregnancy.
The causes of nausea and vomiting in early pregnancy are unknown.
There can be other causes of vomiting unrelated to pregnancy from infective,unrinary or bowel issues etc. so you should be sure that the symptoms are related to pregnancy.
Nausea in later pregnancy may be due to reflux oesophagitis and it responds to antacids.
Nausea and vomiting are very common in pregnancy but are usually mild and only require reassurance and advice.
Nausea in early pregnancy
- Symptoms usually start between 4 and 7 weeks of gestation and ususaly settles by 16 weeks in about 90% of women.
- Check that you are not getting dehydrated and there is no other cause.
- If symptoms begin after 12 weeks of pregnancy, there is usually another cause.
Dietary suggestions which may help some women include:
- Advise the patient to rest; eat small, frequent meals that are high in carbohydrate and low in fat.
- Avoid any foods or smells that trigger symptoms.
- The use of ginger products may be helpful. Evidence is limited and lacks consistency but there is some evidence of benefit over placebo.
- Try eating a dry biscuit first thing on waking in the morning before getting up.
Medication should be avoided in pregnancy unless the benefit outweighs the potential risk, particularly in the first trimester.
Anti-emetics should only be used if dietary measures have failed and symptoms are persistent, severe and preventing daily activities.
There is no evidence that any one anti-emetic is better than another. If medication is required, NICE Clinical Knowledge Summaries (CKS) advice is to use:
- Promethazine or cyclizine first-line.
- Metoclopramide, prochlorperazine or ondansetron second-line
Admission may be needed if becoming dehydrated or persistently vomiting despite anti-sickness medication.