symptoms during pregnancy
women s health issues
Nausea and Vomiting During Early Pregnancy
Doctors first try to determine whether nausea and vomiting are caused by a serious disorder. Morning sickness and hyperemesis gravidarum are diagnosed only after other causes are ruled out. In pregnant women who are vomiting, the following symptoms are cause for concern: Vomiting that persists or that is worsening Abdominal pain Signs of Dehydration , such as decreased urination, decreased sweating, increased thirst, a dry mouth, a rapid heart rate, and dizziness when standing up Fever No movement of the fetus if the pregnancy is 24 or more weeks Confusion, weakness or numbness of one side of the body, speech or vision problems, or sluggishness Women with warning signsshould see a doctor right away. Women without warning signsshould talk to their doctor. The doctor can help them decide whether and how quickly they need to be seen based on the nature and severity of their symptoms. Women who have mild to moderate nausea and vomiting, have not lost weight, and are able to keep some liquids down may not need to see a doctor unless their symptoms worsen. Doctors ask about symptoms and the medical history and do a physical examination. What they find during the history and physical examination often suggests a cause and the tests that may need to be done (see table). Doctors ask about the vomiting: When it started How long it lasts How many times a day it occurs Whether anything relieves or makes it worse How much there is If food and/or liquids are staying down The doctor asks the woman if she has other symptoms, particularly abdominal pain, diarrhea, and constipation, and how her symptoms have affected her and her family—whether she can work and care for herself and her children. The doctor also asks about vomiting in previous pregnancies, about previous abdominal surgery, and use of medications that may contribute to vomiting. During the physical examination, doctors do a routine prenatal evaluation, including measuring the woman's vital signs and evaluating the fetus. They look for signs of serious disorders, such as blood pressure that is too low or too high, fever, or abdominal tenderness. This information helps doctors determine whether vomiting results from the pregnancy or another, unrelated disorder. For example, vomiting is more likely to be due to pregnancy if Symptoms begin during the 1st trimester. Symptoms last or recur over several days to weeks. The woman does not have abdominal pain. There are no symptoms involving other organ systems. Vomiting probably results from a disorder unrelated to the pregnancy if it Began after the 1st trimester Is accompanied by abdominal pain, diarrhea, or both Doctors often use a handheld Doppler ultrasound device, placed on the woman's abdomen, to check for a heartbeat in the fetus. If no heartbeat is detected, doctors do a pelvic ultrasonography to evaluate the fetus and rule out an abnormality. Rarely, nausea and vomiting during pregnancy may be a symptom of a Molar Pregnancy . If the woman is vomiting often or appears dehydrated or if a molar pregnancy is possible, tests are usually done. Which tests are done depend on the cause doctors suspect: Hyperemesis gravidarum:Urine tests (to measure ketone levels) and possibly blood tests (to measure electrolyte levels and other substances) A molar pregnancy:Ultrasonography of the pelvis A disorder unrelated to the pregnancy:Tests specific for that disorder 