Minor Ailments :

Nausea and Vomiting In Pregnancies (NVP)

( Morning Sickness )
Nausea And Vomiting
Nausea and vomiting in Pregnancy (NVP) is the most common condition in
pregnancy .
This common symptoms occurs approximately 50% of pregnancies and is
most marked at gestational weeks 2 12 .
It usually most severe in the morning (Morning Sickness)but can occurs any
time and maybe precipitated by cooking odors and strong sharp smells .
The pathogenesis is poorly understood and the etiology is likely to be
multifactorial .
ConT Nausea And Vomiting
The nausea is probably results from rapidly rising of serum level HCG
(Human Chorionic Gonadotorpin) . During the first trimester , serum level of
HCG maybe as high as 100,00o mIU,mL .
Emotional tension may play a role in the severity of nausea and vomiting .
Extreme nausea and vomiting may be a sign of multiple gestation or molar
pregnancy SHOULD be distinguished from idiopathic NVP .
HUMAN CHORIONIC GONADOTROPIN
(HCG )
HCG is produced during pregnancy
Made by cells that form the placenta ,which nourishes the eggs after it has
been fertilized and becomes attached to the uterine walls
It can first be detected by a blood test about 11 days after conception
and about 12-14 days after conception by a urine test
HCG levels will be double every 72 hours
This levels will reach the peak in the first 8 -11 weeks of pregnancy and
then will decline and level of remainder of the pregnancy
PURPOSE OF HCG
To detect and confirm pregnancy
To help diagnose hydatiform mole of hcG-secreting tumors,threatened
abortion or dead foetus
PROCEDURE OF HCG
DURING PROCEDURE
For verification of pregnancycollect a first-voided morning specimen. If this isnt
possible ,collect a random specimen
For quantitative analysis of hcg ,collect the patients urine over a 24 hour period
in the appropriate container,discarding the first specimen and retaining the
last
Specify the date of the patients last menstrual period on the lab result
Refrigerate the 24 hour specimen or keep it on the ice during collection period
Be sure the test occurs at least 5days after missed period to avoid false-
negative result
INTERPRETATION OF HCG RESULT

In a qualitative immunoassay analysis,result are negative or positive for
hcg
Urine hcg levels in the first trimester of a normal pregnancy may be as high
as 500,000 IU/24hours,in the second trimester ,from 10,000 to 25,000 IU/24
hours
Measurable hcg levels dont normally appear in the urine of men or
nonpregnant women
HYPOGLYCEMIC ATTACK
Hypoglycemic simply means low of blood sugar .if you feel nauseated or battle
with morning sickness so often that it interferes with the amount of food you eat.
You may experience hypoglycemic characteristics such as dizziness ,
lightheadedness ,shakiness or fatigue . Some women experience hypoglycemic as
a result of gestational diabetes . In some women ,the hormonal changes that
accompany pregnancy interfere the way your body uses insulin, another hormone
. Those hormonal changes may also create hypoglycemic-like symptoms ,so its
important to see your doctor for an official diagnosis .
For uncomplicated nausea and vomiting consists of light dry foods , small
frequent meals and emotional support.
Some improvement can be seen with the addition of high dose B6
theraphy and the preconceptional use of prenatal vitamins .
Alternative theraphy such as ginger supplementation , acupuncture ,and
acupressure , maybe beneficial .
Antinausea drug : Promethazine ,Procholoperazine and Metoclopramide
are used only as a final measure .
Treatment for NVP
Health Education / TIPS
Helpful tips to control nausea and vomiting:
What you eat, and when
In the morning, eat a few crackers and rest for 15 minutes before getting up.
Get up slowly and do not lie down right after eating.
Eat small meals or snacks often so your stomach does not become empty (for example,
every two hours). Try not to skip meals.
Eat what you feel like and eat when you are hungry, though you may want to avoid
cooking or eating spicy, fatty or fried foods because of the smell.
If cooking smells bother you, open windows and turn on the stove fan. If possible, ask
someone else to cook. Eat cold food instead of hot, as it may not smell as strongly.
Sniffing lemons or ginger can sometimes help an upset stomach.
Eating salty potato chips can help settle the stomach enough to eat a meal.

Cont Health Education / TIPS
Tips to get enough fluids
Sip small amounts of fluid often during the day.
Avoid drinking fluids during, just before or immediately after a meal.
Food ideas to help relieve nausea
Salty: Chips, pretzels
Tart/sweet: Pickles, lemonade
Earthy: Brown rice, mushroom soup, peanut butter
Crunchy: Celery sticks, apple slices, nuts
Bland: Mashed potatoes, gelatin, broth
Soft: Bread, noodles
Sweet: Cake, sugary cereals
Fruity: Watermelon, fruity popsicles
Liquid: Juice, seltzer, sparkling water, ginger ale
Dry: Crackers
Getting enough rest
Get plenty of rest, and try napping during the day; nausea tends to
worsen when you are tired. Many women find they need more sleep in the
first three months of pregnancy.
You may need to take some time off work or make other arrangements for
household chores and childcare.
Get help and support from friends and family.

Cont Health Education / TIPS
Lifestyle strategies
Get plenty of fresh air and avoid warm places as feeling hot can add to
nausea.
Try acupressure wrist bands.
Acupuncture can help some women. Speak to your health-care professional
first and look for an experienced and licensed acupuncturist.
Try ginger, an alternative remedy thought to settle the stomach. Doses of up to
250 mg four times a day appear to be safe.
If multivitamins make your nausea worse, try taking your prenatal vitamins with
food or just before bed. There are also pills that are smaller or have lower iron
content. If you cant take any multivitamin, take a folic acid pill (0.4 to 1.0 mg)
alone until you feel better

Cont Health Education / TIPS
THANK YOU