April 19, 2012

Nausea and Vomiting in Pregnancy After Infertility Therapy

I’ve waited so long to become pregnant and have been through so much. Now that I finally am, I’m as sick as a dog. Why is this happening to me?

Don’t worry. Your body is not trying to reject the pregnancy that you have worked so hard to have. Nausea and vomiting is extremely common in pregnancy (70-80%) and women with a history of infertility are as likely to experience this as any other pregnant woman.  A continuous spectrum of the severity of nausea and vomiting ranges from the nausea and vomiting that occurs in most pregnancies to the severe disorder called Hyperemesis Gravidarum which occurs in 2% of all pregnancies (about 5 per 1000 pregnancies).  It is thought that nausea is caused by a rise in hormone levels just as it sometimes occurs during ovulation induction; however, the absolute cause remains unknown.

Hyperemesis Gravidarum is characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance.  Women with this condition have increased risk for delivering babies of low birth weight, who are small for gestational age, preterm delivery, and who have low Apgar scores.  Hyperemesis Gravidarum is not preventable, but there are ways of managing it. Severe cases may require hospitalization so that intravenous fluids can be administered and electrolyte balance restored.  Rarely tube feeding and intravenous medications are required.  Milder cases may be treated with:

  • Bed rest, but not too much
  • Dietary changes and antacids
  • Acupressure: The pressure point to reduce nausea is located at the middle of the inner wrist, three fingerbreadths away from the crease between the two tendons. Locate and press firmly, one wrist at a time for three minutes. Seabands also may help with acupressure and can be found at your local drug store
  • Herbs-Ginger or Peppermint
  • Hypnosis
  • Antiemetic Medications: It is important that the risks and benefits be weighed as some drugs may have adverse effects on you or the development of your baby and should only be take under physician supervision

 

Tags: , , , , , , , , , , , , , , , , , , , , ,
Joseph A. Hill, III, M.D.

Joseph A. Hill, III, M.D. Board-Certified in Reproductive Endocrinology and Infertility