womenscure in all means

Do u want to know about “morning sickness in pregnancy “

In first three months of pregnancy,frequently encountered problem is ” nausea and vomiting ” ( NVP ) -called as morning sickness 

  • More than 70% of women experiences morning sickness
  • NVP is usually a self limiting condition
  • NVP starts from 4-7 th week of pregnancy.Peak symptoms occur at 10-16 wk gestation
  • Usually resolves by 20 th week of pregnancy.10% women continue beyond 22 wk
  • Small percentage of women have a more profound course of nausea and vomitings- severe form called as hyperemsis gravidarum
WHY NVP ? 

Hormones : placental hormones are responsible for NVP .Increased levels of HCG hormone having main role in NVP .Placental PG E2 ,IL -1 ,TNF alpha having association.

  • Increased levels of estrogen and progesterone causes nitric oxide production ,there by relaxes the smooth muscle of gut and increase the risk of gastroesophageal reflux and vomiting .
  • Decrease in TSH levels are observed with NVP and serotonin levels tooo

Gastrointestinal  tract dysfunction : relaxation of lower esophageal sphincter and decreased motility of gut increases the risk of NVP

Psychological factors : psychological disturbances like neurotic tendencies ,hysteria,rejection of pregnancy,depression,stress,poverty,marital conflicts …all influences the NVP

WHO ARE MORE PRONE FOR NVP ?? RISK FACTORS : 
  • Younger women
  • In first pregnancy
  • Obese women
  • Low income women
  • Women with less than 12 yrs of education
  • Sedantary lifestyle
  • Housewives
  • Twin gestation
  • Women who had mothers ,who experienced trouble with NVP
  • Personal history of motion sickness
  • Migraine headache
  • History of nausea on OCP’s in the past

MORNING SICKNESS AND OUTCOME OF PREGNANCY : 

  • Uncomplicated nausea and vomiting in pregnancy have been noted to have improved pregnancy outcomes ,fewer miscarriages ,preterm deliveries and still births
  • Fewer instances of foetal low birth weight ,growth retardation and mortality
HOW TO EVALUATE NVP ?
  • If NVP begins after 9 th week of gestation ,other causes should be investigated.When the condition is severe, potentially serious causes need to be ruled out
  • Pyelonephritis common in pregnancy.Kidney ,gallbladder stones and liver disorders to be ruled out .Acute fatty liver ,pre eclamptic toxaemia are seen in pregnancy related nausea and vomiting.
  • Non pregnancy related causes of nausea and vomiting: gastroenteritis ,appendicitis,diabetic ketoacidosis ,hyperthyroidism,vestibular lesions,migraine headaches etc
  • Depending on presenting problem of pregnant women, following investigations can be done .CBP,RBS,urinary ketones,serum electrolytes ,LFT ,RFT,TSH,CUE ,USG abdominal and pelvis

Contd ……

 

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