Treatment for severe morning sickness

Morning sickness is common in pregnancy. It is estimated that up to 90 percent of women who are pregnant will experience some form of nausea and/or vomiting during their pregnancy.

Nausea and vomiting during pregnancy are believed to be in part caused by sensitivity to the hormone of pregnancy – human chorionic gonadotropin. Women who become motion sick easily, who experience headaches or nausea from estrogen and those who have a heightened sense of smell or taste may be more likely to suffer from morning sickness.

If the symptoms are persistent and severe, it is important your OB/GYN rule out gestational trophoblastic disease (molar pregnancy) with blood tests and an ultrasound. Although rare, it can be life-threatening and must be addressed with urgency.

Hyperemesis gravidarum is the term reserved for severe cases of morning sickness. It is when the nausea and vomiting are so persistent that weight loss can occur (usually exceeding 5 percent of pre-pregnancy body weight). In evaluating these cases, a physician must distinguish mild cases from severe because of the potentially harmful effects of dehydration and electrolyte abnormalities, which can present challenges to both the maternal heart and the developing baby. These are difficult to evaluate unless you are seen by your OB/GYN and blood and urine tests can be performed.

Conservative measures are usually recommended before resorting to medication. Although morning sickness can be mild and transient, in many cases it can still be quite debilitating for some. I would never dream of telling a mother-to-be who comes to my office that she has to “live with it.” We usually start with diet modifications and avoiding triggers. Some advocate acupressure wrist bands, although studies have not proven these to be significantly more effective when compared to a placebo.

There has been recent social media buzz about pyriodixine-doxylamine, the FDA’s only pregnancy category, an anti-nausea medicine on the market for morning sickness, thanks to gravidarum celebrities Kim Kardashian and Emily Maynard. There is no contradictory evidence to the effectiveness of this medication, and it is unequivocally safe and recommended by the American College of Obstetricians and Gynecologists as an effective, safe treatment for nausea and vomiting of pregnancy – either pyridoxine alone or combined with doxylamine in the well-known branded medication Diclegis.

If you are suffering from morning sickness, please visit your OB/GYN to learn more about what course of treatment would be best for you.

This story was originally published March 20, 2017 at 3:40 PM with the headline "Treatment for severe morning sickness."