The cause of nausea and vomiting during pregnancy is believed to be rapidly rising serum levels of HCG (human chorionic gonadotropin) secreted by the fetus. Increased estrogen levels have also been implicated. Extreme nausea and vomiting during pregnancy may indicate multiple pregnancy or hydatidiform mole (abnormal tissue growth, not a true pregnancy).

• Symptoms of pregnancy
• Severe nausea
• Persistent excessive vomiting (often leading to weight loss)
• Lightheadedness or fainting

Signs of dehydration may occur, including:

• Ketones in urine
• Increased hematocrit
• Increased pulse rate
• Decreased blood pressure

Blood tests may be recommended for further evidence of dehydration.

Uncomplicated nausea and vomiting may be treated with dry foods (crackers), small frequent meals, and emotional support. It is important for the pregnant woman to maintain her fluid intake; therefore, fluids should be emphasized during the times of the day when she may feel less nauseated.

Medication to prevent nausea is reserved for cases where vomiting is persistent and of adequate amounts to present potential maternal and fetal risks. Severe cases may require hospitalization with IV fluid administration.

An evaluation to rule out abnormalities of the liver or gastrointestinal tract may be indicated in cases of persistent symptoms.

Psychosocial support is an important part of treatment.

Nausea and vomiting usually is worse between 2 and 12 weeks gestation, resolving usually by the 2nd half of a pregnancy.With adequate identification of symptoms and careful follow-up, this should not present serious complications for the infant or mother.

Social or psychological problems may be associated with this disorder of pregnancy. If such problems exist, they need to be identified and addressed appropriately.

Call your health care provider/obstetrician if pregnant and experiencing severe nausea with vomiting.