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Morning Sickness

When the two lines appear on the urine pregnancy kit every woman intending to get pregnant rejoices.But when the nausea and vomiting sets in they wonder why the path to joy has such hurdles .Morning sickness though termed so does not necessarily occur in the morning.It can occur at any time of the day.
It usually starts before 9 weeks of pregnancy and in 90% of cases ends after the 20th week or 5 months into your pregnancy.The cause or aetiology of nausea and vomiting in pregnancy is unknown ,though the relationship with the occurrence of nausea and vomiting and the increase in the hormone human chorionic gonadotropin and its effect on the ovary which in turn increases the hormone estrogen and progesterone has been found to be profound.
Other theories include psychologic predisposition ,evolutionary adaptation to protect the woman from dangerous foods and conditions with increased placental mass such as molar pregnancy and multiple gestations are associated with a higher risk of nausea and vomiting.
Past pregnancy with nausea and vomiting (either mild or severe).Your mother or sister had severe nausea and vomiting of pregnancy.History of motion sickness or migraines may predispose you to have NVP.
Nausea and vomiting in pregnancy or NVP in its milder forms signifies a healthy pregnancy as the progesterone production from the ovary helps enrich the uterus with a thick lining of blood vessels and capillaries so it can sustain the growing baby.But when there is persistent vomiting that is affecting your mood(depression) ,work,your home situation and your ability to care for your family it is must to seek help as early intervention can prevent low birth weights in the baby .
When there is persistent vomiting not caused by any other medical problems ,ketonuria (which is presence of ketones in urine assessed by a simple urine routine test) which usually signifies acute starvation,and a 5% weight loss from the pre-pregnancy weight it is termed hyper emesis gravidarum which requires treatment with medications prescribed by your obgyn.
A simple scoring system consisting of three questions has been developed to ascertain whether your symptoms are of the severe nature or not called the
Modified Pregnancy-Unique Quantification of Emesis/Nausea (PUQE) index.

Total score is sum of replies to each of the three questions.
Nausea Score:
Mild NVP = ≤6
Moderate NVP = 7–12
Severe NVP = ≥13.

If your score is <6 diet and lifestyle changes may help you feel better like:
-Avoiding prenatal vitamins with iron ,folic acid can be continued.
-Try eating dry toast or crackers in the morning before you get out of bed to avoid moving around on an empty stomach.
-Drink fluids often.
-Avoid any foods and smells that trigger symptoms.
-Eat small frequent meals instead of three large meals.
-Try bland foods low in fat and easy to digest like bananas ,rice,applesauce,toast ,potato,pasta and tea.
-Try ginger tea,ginger capsules,ginger candies as ginger has shown to reduce NVP in several studies.
-If u do vomit a lot rinse ur mouth with a teaspoon of baking soda to neutralize the acid from your stomach as it can cause some of your tooth enamel to wear away.
-Take rest as much as you can as this has been shown to relieve symptoms.
If nausea and vomiting still persists even after trying the lifestyle changes it is must that u see your Obgyn as treatment of symptoms earlier the better quality of life and mental health for a pregnant mother.

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