Nausea and Vomiting of Pregnancy

Nausea and Vomiting of Pregnancy

Nausea and vomiting are the most common symptoms experienced in early pregnancy, with nausea affecting 70% to 80% of women. Dry, salty foods are traditionally recommended for resolving nausea or vomiting; however, these foods do not always relieve symptoms.

Foods with the following characteristics are well tolerated: cold, warm, sour, creamy, crunchy, soft, wet, salty, and chocolaty. Incre ased olfactory senses often are a leading cause of nausea during early pregnancy; thus, strong odors and sensitive unpleasant odors should be avoided


Management techniques

Eat small, frequent meals and snacks.

Eat low-fat protein foods and easily digested carbohydrate foods.

Eat dry crackers before rising in the morning.

Avoid spicy foods and gas-forming fruits and vegetables.

Drink fluids between meals (milk is often not well tolerated).

Avoid drinks that contain caffeine or alcohol.

Hyperemesis gravidarum

Hyperemesis gravidarum is a condition characterized by severe, persistent nausea and vomiting that causes dehydration, fluid and electrolyte abnormalities, acid-base disturbances, ketonuria, and weight loss (ie, a 5% decrease from pregravid weight).

Hyperemesis gravidarum occurs in approximately 2% to 5% of pregnant women. Nausea and vomiting of pregnancy and hyperemesis gravidarum begin in the first trimester, usually between weeks 6 and 12, and symptoms often peak between weeks 15 and 17.

Symptoms often begin to decrease by week 20. The pathogenesis of hyperemesis gravidarum is not well understood. Nausea and vomiting of pregnancy and hyperemesis gravidarum are thought to be related to increased secretion of human chorionic gonadotrophin and increased estrogen levels  

Treatment of hyperemesis gravidarum

Treatment of hyperemesis gravidarum depends on the risk level of the patient and the severity of symptoms, such as dehydration and the inability to meet nutrition needs orally. Intensive nutrition counseling and individualized meal planning is the first line of treatment.


If nutrition and behavior modification does not alleviate symptoms, medications, such as metoclopramide (Reglan) and ranitidine (Zantac), or antiemetic drugs, such as prochlorperazine (Compazine) and ondansetron (Zofran), are often prescribed


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