Potential risks or complications associated with morning sickness

A mild case of morning sickness is generally not harmful to either an expectant mom or her baby. In general, a mild case of queasiness is not intense enough to cause any problems with the growth and development of a baby. Waves of nausea and vomiting can lead to a loss of appetite, however. A woman should only really be concerned if her queasiness extends beyond the first 3 or 4 months of her pregnancy or if it is noted that no weight is being gained.

General risk of experiencing morning sickness is higher if:

• A woman has experienced symptoms of nausea and vomiting from migraine headaches, oral contraceptive pills (exposure to oestrogen), motion sickness and certain tastes or smells.
• A woman experienced similar queasiness during a previous pregnancy.
• A woman is experiencing pregnancy for the very first time.
• A woman is expecting more than one baby during her pregnancy.
• A woman is obese and has a body mass index (BMI) of 30 or more.
• A woman is highly stressed.

Hyperemesis gravidarum explained

Severe morning sickness can develop in about 1 to 2% of pregnancies, around about the 6th week. For most expectant mom’s morning sickness usually subsides around the 12th week. It can sometimes persist in waves throughout the full 9-month pregnancy period. The thing to remember is that morning sickness, even if severe, is temporary and will pass following the birth of a baby.

When morning sickness becomes intense, it can be quite debilitating for a pregnant woman, making it difficult to comfortably continue with daily activities.

Risk for hyperemesis gravidarum is higher if:

• A woman is expecting a female baby.
• Other women in the family history have experienced this intense form of morning sickness.
• A woman has experienced intense morning sickness during a previous pregnancy.

Constant vomiting is usually the most distinguishable way to assess whether a pregnant woman has a case of hyperemesis gravidarum. This can lead to severe dehydration and weight loss (about 5% is common), which can place the body under intense stress and cause serious complications for an expectant mom and her growing baby. A severe case of morning sickness can persist for at least 9 to 13 weeks, but may only ease off by the 20th week of pregnancy. In some cases, a severe case can even persist further.

Other complications which can develop as a result include:

• Impaired kidney function – this can lead to a reduction in the amount of urine being passed.
• Low levels of electrolytes (sodium and potassium) – this can lead to hypokalaemia, body weakness, dizziness and blood pressure changes.
• Alkalosis – a dramatic drop in normal acidity levels in the blood.
• Increase in the production of saliva – this can lead to an increase in swallowing which can aggravate nausea.
• Muscle weakness – this is usually as a result of low levels of electrolytes and malnutrition.
• Tears in the oesophagus – as a result of constant vomiting.

There is no cure for hyperemesis gravidarum, but on the plus side, it is as temporary as pregnancy, and it can be managed. There is also currently no known way to prevent morning sickness or avoid it intensifying to this level.

A medical doctor does need to treat a woman in this condition. Aside from her own discomfort, there is an increased chance that the effects will extend to a growing baby. Potential complications in this instance include premature birth and a low birth weight. This can place a fragile new-born at higher risk of further health complications.

Treatment for hyperemesis gravidarum includes:

• Meals and beverages: Not all cases of intense morning sickness will require immediate hospitalisation. If some foodstuffs or liquids are able to be ingested, a doctor may recommend smaller, more frequent intake. Liquids can be drunk in smaller quantities, more often and through a straw. For many women, warm or hot foods may trigger bouts of nausea, and thus cold foods may stay down for longer. An electrolyte liquid (replacement sports drink) may also help. Ginger can also have a calming effect on the body and help to alleviate nausea. Several, small doses (around 1 to 1 and a half grams) can be taken as a supplement or in tea. Nutritional supplements, especially thiamine (vitamin B1) in doses of about 1 and half milligrams can also ease discomforts of nausea and vomiting, although these should be discussed with a doctor before being administered.
• Medications: These may be recommended or prescribed by a doctor in oral, suppository, or intravenous (IV) form as a way to alleviate morning sickness. IV steroids or over-the-counter antacids may also provide some relief. Any medications that are recommended or prescribed will be safe for you to take with no direct impact on a growing baby.
• Hospitalisation: If necessary, a woman may be admitted to hospital for care and treatment. This will involve the administering of intravenous fluids (usually saline, electrolytes and vitamins) to help restore hydration, tube feeding (nutritious foodstuffs are given through a tube through the nose, down the oesophagus and into the stomach), or IV feeding (if the digestive tract is impaired or unable to function properly). Once able to hold down food and hydration to the body has been restored, a woman will be discharged with care instructions to be implemented at home.