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1st trimester nausea medication

Your body has resources to protect the baby during early pregnancy nausea and vomiting. Instruction for nausea combo medication. These medications are similar. Try to be proactive and contact me early if you think things are spiralling out Metoclopramide (Maxolon, Pramin) – a simple anti-nausea medication taken. Prescription Medications for Morning Sickness · Diclegis · Zofran (expensive, not always covered by insurance) · Phenergan (pill and suppository.

You can watch a thematic video

PREGNANCY UPDATE: THE FIRST TRIMESTER - HYPEREMESIS GRAVIDARUM STORY \u0026 TREATMENT - Ysis Lorenna
1st trimester nausea medication
1st trimester nausea medication

Is it safe to take anti-sickness medication when pregnant?

In a nutshell

Most anti-sickness (anti-emetic) medication is safe to take during pregnancy but a doctor should always prescribe anti-emetic drugs, and it’s worth trying natural alternatives first.

The expert view

If you’re really struggling with sickness during your pregnancy, there’s good news: anti-sickness medications are safe to take during pregnancy if prescribed by a doctor. Anti-sickness drugs have had a difficult history – see more below – but rest assured, there is medicine you can take which won’t harm your baby.

“There is medication that is safe to use in pregnancy,” confirms midwife Anne Richley, “but it should always be prescribed by a doctor, not bought over the counter.”

The NHS commonly prescribes antihistamines like Promethazine and Cyclizine to treat pregnancy sickness and taking anti-emetic drugs, like Prochlorperazine (Stemetil) or Metoclopramide, is another way of easing pregnancy nausea.

These drugs work either by blocking the signals from and to your the part of your brain that controls the sickness mechanism, or by encouraging your stomach to empty faster, so there’s nothing to bring up. You may also be prescribed vitamin B6, which may help relieve pregnancy nausea for some women, though it doesn’t reduce vomiting.

So when might you need to take anti-sickness drugs?

While more than half of pregnant women suffer with morning sickness, most mums-to-be are able to get through it and find the sickness eases by around week

However, some women have really severe sickness, called hyperemesis gravidarum. This affects around % of pregnancies, and became well known when 1st trimester nausea medication Middleton, the Duchess of Cambridge, suffered from it when she was pregnant with Prince George. 

According to mynewextsetup.us, if your symptoms are, “persistent, severe and preventing daily activities” and typically last beyond week 20 of your pregnancy, you may need treatment with drugs. 

If you feel you’re not coping with pregnancy nausea, do talk to your midwife or doctor. 

There are also more serious sickness symptoms, which mean you should contact your GP or midwife immediately. These are:

  • if you’re unable to keep food or any fluids down for 24 hours
  • you don’t wee for more than 8 hours and your urine is dark coloured
  • you feel very weak, dizzy or faint when you stand up
  • you have stomach pains
  • you have a high temperature – 38°C (°F) or above
  • your sick contains blood

But aren’t anti-sickness drugs dangerous in pregnancy?    

In the 60s a drug called Thalidomide was used to treat morning sickness. This did prove to be dangerous to unborn babies and was banned from use to treat pregnancy sickness.

The medications doctors now prescribe are largely considered safe and effective, although as with all medicines there can be side effects and it’s generally best to avoid medication when you’re pregnant if you can.

One study of more thanwomen found babies born to mums who had taken an antihistamine during their pregnancy were no more likely to have something wrong with them than 1st trimester nausea medication whose mothers had not taken one. And another study of 40, women proved that taking metoclopramide didn’t increase the risks birth defects or miscarriage.

How can I cope without taking medication?

There walking the west highland way in 4 days also lots of ways to stop feeling and being sick that don’t involve a visit to the pharmacy.

“There are various things that you can try to reduce the symptoms before using drugs,” says Anne. “Try eating little and often. Also, acupressure bands, often used for travel sickness, can work wonders.”

Other suggested natural treatments include including more ginger in your diet, eating dry, bland foods first thing in the morning, acupuncture and wearing clothes that don’t feel tight around the waist. 

Mums writing in our forum say:

“I was given Prochlorperazine when I was 10 wks pregnant with my DD. I had suffered from about 5 weeks and lost almost a stone. I visited my GP every week and begged them to help me but it took until 10 weeks for them to prescribe them (they worked great once I got them). I had to take anti sickness tablets until I was 26wks.” baby_blaylock

“Have had really bad case of hyperemesis gravidarum since 6 weeks pregnant. Got medication from doctor but nothing seemed to really kick it but……last few days have become increasingly better and without jinxing myself I don’t feel sick today! Am hoping that this is the start of me turning a corner. Fingers crossed!” tiger

“I had Hyperemesis and lost 2 stone in a matter of weeks. Everyone kept saying it’s just morning sickness you have to force yourself to eat but I couldn’t even keep water down. When I saw my consultant my urine sample was neon orange and she said she’d never seen anything like it and wanted me on a drip now. I was put on medication and luckily it stopped me being sick but the nausea was there throughout the pregnancy. There are a lot of foods I still can’t eat because of it. There’s only so many times you can throw something up and still want to eat it.” Lucian3

Read more…

Источник: mynewextsetup.us

Taking Ondansetron During Pregnancy Does Not Appear to Increase Risk For Birth Defects

Woman sitting on bed feeling sick, while man sleeps

A study from the Slone Epidemiology Center at Boston University, in collaboration with the Centers for Disease Control and Prevention (CDC), found that taking ondansetron during early pregnancy did not appear to increase the chance of having a baby with a birth defect. Ondansetron (Zofran®) is a medicine used to treat nausea and vomiting that may be caused by surgery, chemotherapy, or radiation therapy. Healthcare professionals also prescribe ondansetron during pregnancy to reduce symptoms of nausea and vomiting, also known as “morning sickness.”

Read the full scientific articleexternal icon.

Main Findings

  • In this study:
    • About 7 in 10 mothers reported “morning sickness” during the first three months of pregnancy.
    • Use of ondansetron by pregnant women increased from about 1 in before to about 1 in 10 by
  • For most of the birth defects studied, researchers found that taking ondansetron during early pregnancy did not appear to increase the chance of having a baby with a birth defect.
  • Women should discuss options for managing nausea and vomiting symptoms during pregnancy with their healthcare providers.

About This Study

About Birth Defects

Birth defects are common, costly, and critical conditions that affect 1 in every 33 babies born in the United States. Birth defects are structural changes present at birth that can affect almost any part or parts of the body (such as the heart, brain, face, arms, and legs). They may affect how the body looks, works, or both.

Treating for Two: Safer Medication Use in Pregnancy

Our Work

CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) is working to improve the health of women and babies through its Treating for Two: Safer Medication Use in Pregnancy initiative. Treating for Two works to understand trends in medicine use among pregnant women and women of reproductive age, and provide women and healthcare providers with information about the safety or risk of using specific medicines during pregnancy. This information will allow women and their doctors to make informed treatment decisions about health conditions during pregnancy.

To learn more about our work in this area, visit the Treating for Two website.

More Information

Key Findings Reference

Parker SE, Van Bennekom C, Anderka M, & Mitchell AA. Ondansetron for Treatment of Nausea and Vomiting during Pregnancy and the Risk of Birth Defects. Obstetrics & Gynecology. ; (2):

Источник: mynewextsetup.us

LITTLE FALLS, N.J., June 10 -- The use of metoclopramide for treating nausea and vomiting during the first trimester of pregnancy appears to pose no risk for the fetus, a retrospective database study showed.


There were no increased risks of congenital malformations, low birth weight, preterm delivery, or perinatal death when the drug was used in the first 13 weeks of gestation, Rafael Gorodischer, M.D., of Soroka Medical Center in Beer-Sheva, Israel, and colleagues reported in the June 11 issue of the New England Journal of Medicine.

  • Explain to interested patients that the study authors said these findings should reassure clinicians who use metoclopramide as the drug of choice for nausea and vomiting during pregnancy.
  • Point out that this study could not assess whether women actually took the prescribed medications.


Although metoclopramide is not the first-line treatment for nausea and vomiting during pregnancy in the U.S. and Canada, it is the drug of choice in several countries, including Israel, the researchers said.


In North America, clinicians first turn to pyridoxine and the antihistamines doxylamine and promethazine -- in that order -- with metoclopramide reserved if those treatments fail, according to an algorithm from the American College of Obstetricians and Gynecologists.


Jennifer Niebyl, M.D., of the University of Iowa Hospitals and Clinics in Iowa City, called the findings reassuring and said, "I think people will probably use [metoclopramide] earlier in the algorithm of treating nausea and vomiting in early pregnancy."


Dr. Niebyl, who was not involved in the study, said metoclopramide could be used as a first-line agent, "although most of the recommendations have been to use antihistamines first because there has been more safety data on them."


"These findings provide reassurance regarding the safety of metoclopramide for the fetus," the researchers wrote.


Using three linked healthcare databases, the researchers tracked the use of metoclopramide in 81, women ages 15 to 49 who had a singleton delivery at Soroka Medical Center.


Overall, 3, (%) received metoclopramide.


After adjusting for parity, maternal 1st trimester nausea medication, ethnic group, maternal diabetes, smoking status, and peripartum fever, exposure to metoclopramide was not significantly associated with any of the following outcomes:

  • Major congenital malformations (OR95% CI to )
  • Minor congenital malformations (OR95% CI to )
  • Low birth weight 1st trimester nausea medication95% CI to )
  • Preterm delivery (OR95% CI to )
  • Low Apgar score at one minute (OR95% CI to )
  • Low Apgar score at five minutes (OR95% CI to )
  • Perinatal death (OR95% CI to )


In addition, there was no significant dose-response effect between metoclopramide and the risk of major congenital malformations (P=).


The findings were similar among women who refilled their prescription at least once.


The researchers acknowledged that the use of healthcare databases precluded the evaluation of whether the women actually took the prescribed medications.


Other limitations included the possible misclassification of outcomes, the lack of data on spontaneous abortions, and possible confounding given the observational design of the study.


As an example of possible confounding, the results may have been affected if women taking metoclopramide had more nausea and vomiting than women who did not take the drug, they 1st trimester nausea medication.


"A significant association has been reported between nausea and vomiting during pregnancy and more favorable pregnancy outcomes," they explained. "This association might potentially mask some adverse effects of metoclopramide."

One of Dr. Gorodischer's co-authors reported receiving consulting and lecture fees, as well as grant support, from Duchesnay. No other potential conflicts were reported.
Источник: mynewextsetup.us

Overview - Morning sickness (nausea and vomiting)

How to cope with morning sickness

Rest

Get plenty of rest - being tired can make you feel worse.

If you have children at home, try to go to bed when they do.

Give yourself time to get out of bed if you feel sick in the mornings. Sit up slowly and wait a few minutes before standing. Moving very quickly can make you feel sick or dizzy.

Loud noises and bright lights can trigger sickness in some women. 

Eat small amounts often

It can be hard to eat a healthy diet when you are not feeling well. Don't worry if your diet isn’t the healthiest when you are sick.

Aim to eat little and often throughout the day. Eat enough to keep your energy levels up and prevent weight loss.

Things you can do

  • Nibble your favourite foods every 2 hours - long gaps without food will make nausea worse.
  • Dry and plain foods are easiest to tolerate, such as dry toast, biscuits, crackers, pasta, rice, dry cereal and cereal bars.
  • Bring some dry crackers to bed with you to eat when you wake. Wait about minutes before slowly getting up after eating the crackers.
  • Keep your meals simple.
  • Have easy-to-prepare foods in the house, such as beans or ready made meals.
  • Eat foods that have lots of energy in a small amount, such as nuts, cheese, hummus, full-fat yogurt, avocado.
  • Eat more when you are hungry – do not wait for mealtimes.

Avoid food smells

Some cooking smells may make you feel sick. Having easily- prepared or ready-to eat foods in the house is useful so that you can avoid cooking.

When food is being cooked you could go out for a short walk, or sit in a different room with a window open.

To block out smells, try putting a scented handkerchief to your nose. Use a scent that you find soothing, like essential oil or fresh cut lemons.

Try ginger

Eating foods or drinks that contain ginger may help to reduce mild nausea and vomiting. Check with your pharmacist before taking a ginger supplement to make sure it's safe for your pregnancy. 

Take folic acid

Take folic acid at the time of the day you are feeling best.

Some women choose to take a multivitamin throughout their pregnancy. This can be difficult to take for some women while they are not feeling well.

Some brands have a liquid form of antenatal multivitamins. Sometimes this can be easier to take.

Folic acid when planning a pregnancy

Rinse your teeth after being sick

If you vomit, rinse your mouth out with water. Your teeth will be softened by your stomach acid, so do not brush straight away. Wait about an hour to brush your teeth.

Oral hygiene can be difficult when you have severe morning sickness. But it's important to look after your teeth and gums.

Источник: mynewextsetup.us

If you are pregnant or thinking of becoming pregnant, there’s no way to know for sure if you will suffer any morning sickness but your chances are pretty high. About 70 to 80 percent of women experience nausea in the first 12 weeks of pregnancy, and about 50 percent experience some vomiting. Some women never experience morning sickness, while others may feel sick throughout their entire pregnancy. You might have no morning sickness while pregnant with your first child and then not be as lucky with the next one. The key is to be prepared and know ahead of time how to best relieve morning sickness if it comes.

Here are some tips to relieve morning sickness:

Eat 1st trimester nausea medication meals instead of big meals.

Break up the portions and timing of your meals. Hormones produced during pregnancy, especially in the first trimester, slow down your digestive system muscles making it harder to digest larger meals. Eat smaller portions and eat more frequently throughout the day. Having an empty stomach or low blood sugar can cause nausea or make nausea worse. Eating small meals every few hours can keep your blood sugar steady and your stomach feeling full, but not too full. If you’re battling morning sickness, also stay away from spicy foods. You’ll want to eat foods you know are easy to digest.  

Drink before or after a meal, not during.

Staying hydrated is important, especially if you’re vomiting. Drink small amounts of fluid throughout the day, but limit fluid intake during meals to avoid feeling too full. Drink 30 minutes before or after a meal instead. If you prefer routing number rockland trust ma with your meal, have a small glass of water rather than a beverage containing sugar, as too much sugar open 5 3 bank account online upset your stomach.

Avoid cooking odors as much as possible.

If you can have someone else cook for you, that is ideal. If that’s not an option, ventilate your kitchen well while cooking. Open the windows, use the fan and, as long as nothing is cooking on the stovetop, leave the room to avoid inhaling cooking odors. Avoiding scents and odors in general is a good idea—perfumes, air fresheners, trash, etc.—especially when you’re not feeling well.

Avoid warm places.

Feeling hot can add to your nausea and make you feel even worse. Stay away from crowded, warm spaces that might overheat you or make you feel closed in. Cool air can bring relief, so seek air conditioning when heat and humidity is high or starts to bother you. Don’t wait until you’re overheated.  

Get as much rest as possible…but not right after eating.

Good news! Naps are recommended for pregnant women. Carrying a baby inside you takes energy and being sick saps that energy. Rest at intervals during the day, if you can. Take more frequent small breaks at work to change position, walk around and get fresh air. Also, do not lie down right after eating. Give your body time to digest the food first. Establish a good, calming pre-sleep routine at night to help you fall asleep more easily. Turn lights down and stay away from digital screens and devices an hour before your bedtime, if possible.

Keep ginger, lemons and watermelon handy.

While certain smells can make your nausea worse, sniffing certain fresh scents may help. Sniff fresh cut lemons or ginger for nausea relief. Drinking lemonade, ginger ale and eating watermelon works for many women as well. Ginger is proven to be effective tim and faith fargodome treating and preventing symptoms of morning sickness. Keep ginger candies on hand to help relieve nausea or make your own ginger tea. Peel and slice fresh ginger root, then add a 2-inch piece to boiling water. Let steep for 5 to 10 minutes, then strain into a cup. Sip or drink slowly to enjoy.

Take Dramamine®-N Multi-Purpose to relieve nausea.

Many people know the Dramamine® brand as a reliable remedy for motion sickness, but we also have a formula made to relieve the type of nausea and vomiting that comes with morning sickness during pregnancy. Dramamine®-N Multi-Purpose Formula is formulated with ginger extract to naturally relieve nausea and is safe for pregnant women.

Easily find where to buy Dramamine®-N  and check our Special Offers page for money-saving coupons. 

When to call your doctor

If you’re experiencing morning sickness, you should tell your doctors. They will want to keep tabs on how severe it is and how long it lasts into 1st trimester nausea medication pregnancy. If you experience severe morning sickness—excessive nausea and vomiting—where you are unable to eat or drink, or if you have pain and fever with vomiting, call your doctor as soon as possible.

Relieve morning sickness with Dramamine®

Источник: mynewextsetup.us

Dr Rachel Ryan

Nausea and Vomiting in Pregnancy

Nausea and vomiting in pregnancy (known formally as hyperemesis gravidarum or, more commonly, as morning sickness) is very common, particularly in the first trimester.  For most women, this is certainly annoying, but relatively mild and manageable.  In most cases, symptoms begin to settle towards the end of the first trimester.

Some women, however, are not so lucky.  For some women symptoms continue until much later in the pregnancy (for some, they continue throughout the entire pregnancy) and some women can become quite dehydrated and start to lose weight.  Ideally, we want to avoid getting to the stage that you become dehydrated and start to lose weight.  This is not a great situation for the body to be in generally and, as you might imagine, not the best environment for a developing fetus.  If you are having trouble eating how to activate us bank debit card and are struggling to keep down fluids, you should contact me.

Here are some of the ways we can address nausea and vomiting in pregnancy, starting from the simplest measures and progressing up to the more intensive treatments.  Most people find they can manage their symptoms with a few of the more simple measures and very few people require the more full-on treatments.  Try to be proactive and contact me early if you think things are spiralling out of control.  The earlier we are able to treat you, the more likely we are to be able to use the simple methods only.

Simple lifestyle changes:

You may find that some activities make you vomit.  If you can, you should try to avoid these.  For example, if cooking meat makes you gag, see if someone else can take over that task until you’re feeling better.  If brushing your teeth makes you vomit, try rinsing with mouthwash instead – your teeth won't get quite as clean but this is OK in the short term (I’m not suggesting mouthwash as a longterm substitute for 1st trimester nausea medication and flossing!)

Try not to get too tired, as being tired will make your nausea worse.  Often, this is much easier said than done – but try not to pack too much into your evenings and weekends and take the opportunity to rest when you can.

Simple dietary measures:

Eat small meals frequently – letting yourself get really hungry may make you nauseated, as may large meals.  If you are on the go, it may help to carry some simple snacks with you, to nibble on from time to time.

Eat whatever you can manage – if all you can keep down is toast, then eat toast.  Don’t eat broccoli just because it’s good for you, if it makes you nauseated.

Have food and fluids separately – some people find that having a drink with a meal can make nausea worse so try separating your meals and your drinks.

Water is not the only fluid – if it makes you fell sick (some pregnant women find that they don’t like the ‘taste’ of water in the first trimester) try drinking fruit juice, sports drinks or cordial instead.  These drinks are all pretty sweet so you may want to dilute them.  Remember the important thing is to keep your fluids up – the kind of fluid you drink is less important.

Simple ‘remedies’:

Ginger – some women find ginger to be helpful.  This can be in the form of tablets, gingerale or ginger beer, cordials, tea, ginger flavoured sweets or ginger in the food you eat.  The evidence for ginger as a treatment is not great but it may work for you and, unless you really don’t like ginger, it’s probably worth a try.

Vitamin B6 – again the evidence is not great that this actually works but it may be worth a try.

Medication:

A variety of medication is available to help with morning sickness for women who need it.  Rest assured that I will not prescribe anything that is dangerous for your baby, so anything that I recommend for you will be quite safe.  If you get to the stage that you need medication, the best approach is to take it regularly until your symptoms are well under control and then to reduce the dose gradually.  Waiting until 1st trimester nausea medication are desperate and then using the smallest amount possible does not really work all that well.  Medications we may use include:

Metoclopramide (Maxolon, Pramin) – a simple anti-nausea medication taken anywhere from once to four times a day.  This medication has been used for capital one apply for first credit card long time in pregnancy and has a long record of safety.  It can be given as a tablet or an intravenous or intramuscular injection.

Ondansetron (Zofran) – also safe in pregnancy, this medication is better at treating nausea than metoclopramide but has the disadvantage of being quite expensive.  It comes in wafer form for women who are too sick to swallow tablets and can also be given intravenously.

Sedating antihistamines – particularly useful at night

Corticosteroids – women with severe nausea and vomiting that hasn’t settled down with other treatments may improve with a shot course of steroids (not the same sort of steroids that body builders take) which are safe in pregnancy.

Intravenous fluids:

If other methods have failed and you are significantly dehydrated, we may need to arrange for you to be admitted for IV rehydration.  We can give IV anti nausea medication at the same time.  Some women may need to spend a few days in hospital.  For other women, it may be possible to come in two or three times a week as an outpatient for some IV fluids to help maintain adequate hydration (dehydration makes nausea worse).

So, you can see that there are lots of different options for treating nausea and vomiting in pregnancy, all of which are quite safe.  While mild nausea is common and self limiting, please contact me if your symptoms are more severe and we can work out a treatment plan that is appropriate for your situation.

Источник: mynewextsetup.us

Morning sickness relief - information and support

Pregnancy sickness – or morning sickness – is thought to be a reaction to high levels of pregnancy hormones, in particular human chorionic gonadotropin (hCG). These hormones rise quickly during the first few weeks of pregnancy.

Pregnancy sickness is often at its worst when you first wake up, which is why it is called morning sickness, but it can happen at any time of day.

For most women, the first 12 weeks are the worst. After that you should slowly start to feel better. By around weeks, you will probably find that the sickness has completely gone away.

Not every pregnant woman will get morning sickness. Pregnancy symptoms vary a lot, so don’t worry if you don’t have one of them.

Is there a cure for morning sickness?

No, there is no surefire way of stopping morning sickness. But there are some things that may give you some relief. These ideas have not been scientifically proven to work but they have helped some women, so you might like to try them out:

  • Eat little and often. Try eating six small meals a day instead of three big meals.
  • Rest. When you are tired the sickness can get worse.
  • Avoid foods with lots of sugar or saturated fats – such as sweets, chocolate and red meat.
  • Carbohydrates – things like bread, rice, potatoes and pasta – can be easier to eat when you’re feeling nauseous.
  • If possible, keep away from ‘triggers’ – food or smells that make you feel sick.
  • Have a small snack before getting up in the morning – something like dry toast or crackers.
  • Try foods or drinks that have ginger in them. You could try ginger biscuits, crystallised ginger or ginger herbal tea.
  • Try wearing acupressure bands throughout the day. You can buy elastic acupressure wristbands from most pharmacies. These bands have a plastic button that presses on the acupressure point on the wrist and it may help relieve the nausea.

What should I do if I get morning sickness at work?

This can be challenging, especially if you’re not ready to tell your colleagues about your pregnancy.

If you feel very ill it’s probably a good idea to tell your manager at work at work that you’re pregnant, but you don’t have to.

If you do decide to tell them about your pregnancy, this is a good time to talk about any changes to your work that might mynewextsetup.us example, you might need easier access to a toilet. Or if smells from the kitchen or canteen are triggering your sickness, maybe you could move somewhere else until you feel better.

Try not to worry too much about people knowing you are pregnant – it’s more important to look after yourself.

What if my morning sickness is really bad?

If you can’t keep any food or drink down, or you are worried at all about pregnancy sickness, see your midwife or doctor. You may have a condition called hyperemesis gravidarum.

What is hyperemesis gravidarum?

Hyperemesis gravidarumis a condition which causes excessive sickness and vomiting in pregnancy.

Symptoms of hyperemesis gravidarum

Other than severe nausea and sickness, you may also notice:

  • dark concentrated urine
  • weeing less often
  • feeling faint or dizzy
  • losing weight
  • blood in your vomit
  • a high temperature
  • low blood pressure.

If you are vomiting several times a day or are not able to eat and drink at all without being sick, you may be dehydrated, which is why you feel so bad.

Treating hyperemesis gravidarum

There are several medicines that are safe to use in pregnancy, including anti-sickness drugs (anti-emetics) or steroids. If you’re too sick to keep anything down, they can be given by injection.

You may also be prescribed a vitamin B supplement, which can help as well.

Hyperemesis can also affect how you feel emotionally and you may need some support with this.

If your sickness is really severe and you’re struggling to control it, you may need to go into hospital for treatment. This will usually be for a few days so the doctors can assess the condition and work out the best way to manage it for you and your baby.

Support for hyperemesis gravidarum (HG)

Источник: mynewextsetup.us

1st trimester nausea medication -

LITTLE FALLS, N.J., June 10 -- The use of metoclopramide for treating nausea and vomiting during the first trimester of pregnancy appears to pose no risk for the fetus, a retrospective database study showed.


There were no increased risks of congenital malformations, low birth weight, preterm delivery, or perinatal death when the drug was used in the first 13 weeks of gestation, Rafael Gorodischer, M.D., of Soroka Medical Center in Beer-Sheva, Israel, and colleagues reported in the June 11 issue of the New England Journal of Medicine.

  • Explain to interested patients that the study authors said these findings should reassure clinicians who use metoclopramide as the drug of choice for nausea and vomiting during pregnancy.
  • Point out that this study could not assess whether women actually took the prescribed medications.


Although metoclopramide is not the first-line treatment for nausea and vomiting during pregnancy in the U.S. and Canada, it is the drug of choice in several countries, including Israel, the researchers said.


In North America, clinicians first turn to pyridoxine and the antihistamines doxylamine and promethazine -- in that order -- with metoclopramide reserved if those treatments fail, according to an algorithm from the American College of Obstetricians and Gynecologists.


Jennifer Niebyl, M.D., of the University of Iowa Hospitals and Clinics in Iowa City, called the findings reassuring and said, "I think people will probably use [metoclopramide] earlier in the algorithm of treating nausea and vomiting in early pregnancy."


Dr. Niebyl, who was not involved in the study, said metoclopramide could be used as a first-line agent, "although most of the recommendations have been to use antihistamines first because there has been more safety data on them."


"These findings provide reassurance regarding the safety of metoclopramide for the fetus," the researchers wrote.


Using three linked healthcare databases, the researchers tracked the use of metoclopramide in 81, women ages 15 to 49 who had a singleton delivery at Soroka Medical Center.


Overall, 3, (%) received metoclopramide.


After adjusting for parity, maternal age, ethnic group, maternal diabetes, smoking status, and peripartum fever, exposure to metoclopramide was not significantly associated with any of the following outcomes:

  • Major congenital malformations (OR , 95% CI to )
  • Minor congenital malformations (OR , 95% CI to )
  • Low birth weight (OR , 95% CI to )
  • Preterm delivery (OR , 95% CI to )
  • Low Apgar score at one minute (OR , 95% CI to )
  • Low Apgar score at five minutes (OR , 95% CI to )
  • Perinatal death (OR , 95% CI to )


In addition, there was no significant dose-response effect between metoclopramide and the risk of major congenital malformations (P=).


The findings were similar among women who refilled their prescription at least once.


The researchers acknowledged that the use of healthcare databases precluded the evaluation of whether the women actually took the prescribed medications.


Other limitations included the possible misclassification of outcomes, the lack of data on spontaneous abortions, and possible confounding given the observational design of the study.


As an example of possible confounding, the results may have been affected if women taking metoclopramide had more nausea and vomiting than women who did not take the drug, they said.


"A significant association has been reported between nausea and vomiting during pregnancy and more favorable pregnancy outcomes," they explained. "This association might potentially mask some adverse effects of metoclopramide."

One of Dr. Gorodischer's co-authors reported receiving consulting and lecture fees, as well as grant support, from Duchesnay. No other potential conflicts were reported.
Источник: mynewextsetup.us

Doxylamine and Pyridoxine

pronounced as (dox il' a meen) (peer i dox' een)

The combination of doxylamine and pyridoxine is used to treat nausea and vomiting in pregnant women whose symptoms have not improved after changing their diet or using other non-medicine treatments. Doxylamine is in a class of medications called antihistamines. It works by blocking the action of certain natural substances in the body that may contribute to nausea and vomiting. Pyridoxine (vitamin B6) is a vitamin. It is given because a lack of pyridoxine in the body may also be a factor in causing nausea and vomiting during pregnancy.

The combination of doxylamine and pyridoxine comes as a delayed-release (releases the medication in the intestine to delay when the medication will start working) tablet and as an extended-release (long-acting) tablet to take by mouth. It is usually taken on an empty stomach (at least 1 hour before or 2 hours after a meal) with a full glass of water. At first, your doctor will usually tell you to take it once a day at bedtime. If your symptoms of nausea and vomiting are not better, then your doctor may tell you to take the delayed-release tablet two or three times a day, or the extended-release tablet two times a day. . Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take doxylamine and pyridoxine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended-release and delayed-release tablets whole; do not split, chew, or crush them.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking doxylamine and pyridoxine,

  • tell your doctor and pharmacist if you are allergic to doxylamine (Unisom); pyridoxine (vitamin B6); other antihistamine medications including carboxamide (Arbinoxa), clemastine (Tavist), dimenhydrinate (Dramamine), diphenhydramine (Benadryl), and promethazine (Phenergan); any other medications; or any of the ingredients in doxylamine and pyridoxine delayed-release or extended-release tablets. Ask your pharmacist for a list of the ingredients.
  • tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate). Your doctor will probably tell you not to take doxylamine and pyridoxine if you are taking one or more of these medications.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: medications for colds, hay fever, or allergies; medications for depression; muscle relaxants; narcotic medications for pain; sedatives; sleep medications; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had asthma or other breathing problems, increased pressure in the eye or glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision), ulcers, intestinal blockage, or difficulty urinating.
  • tell your doctor if you are breastfeeding. You should not breastfeed while taking doxylamine and pyridoxine.
  • you should know that doxylamine and pyridoxine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • avoid alcoholic beverages or products containing alcohol while taking doxylamine and pyridoxine. Alcohol can add to the drowsiness caused by this medication.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule Do not take more than four delayed-release tablets or more than two extended-release tablets in a day. Do not take a double dose to make up for a missed one.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). If your medication came with a desiccant canister (small canister that contains a substance that absorbs moisture to keep the medication dry), leave the canister in the bottle.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (mynewextsetup.us) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. mynewextsetup.us

In case of overdose, call the poison control helpline at Information is also available online at mynewextsetup.us If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at

Symptoms of overdose may include the following:

  • restlessness
  • dry mouth
  • dilated pupils (black circles in the centers of the eyes)
  • drowsiness or sleepiness
  • dizziness
  • confusion
  • seizures
  • fast, irregular, or pounding heartbeat
  • difficulty urinating or painful urination
  • muscle pain or weakness
  • buildup of fluid in the body
  • dark red or cola-colored urine

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Last Revised - 02/15/

Browse Drugs and Medicines

Источник: mynewextsetup.us

Is it safe to take anti-sickness medication when pregnant?

In a nutshell

Most anti-sickness (anti-emetic) medication is safe to take during pregnancy but a doctor should always prescribe anti-emetic drugs, and it’s worth trying natural alternatives first.

The expert view

If you’re really struggling with sickness during your pregnancy, there’s good news: anti-sickness medications are safe to take during pregnancy if prescribed by a doctor. Anti-sickness drugs have had a difficult history – see more below – but rest assured, there is medicine you can take which won’t harm your baby.

“There is medication that is safe to use in pregnancy,” confirms midwife Anne Richley, “but it should always be prescribed by a doctor, not bought over the counter.”

The NHS commonly prescribes antihistamines like Promethazine and Cyclizine to treat pregnancy sickness and taking anti-emetic drugs, like Prochlorperazine (Stemetil) or Metoclopramide, is another way of easing pregnancy nausea.

These drugs work either by blocking the signals from and to your the part of your brain that controls the sickness mechanism, or by encouraging your stomach to empty faster, so there’s nothing to bring up. You may also be prescribed vitamin B6, which may help relieve pregnancy nausea for some women, though it doesn’t reduce vomiting.

So when might you need to take anti-sickness drugs?

While more than half of pregnant women suffer with morning sickness, most mums-to-be are able to get through it and find the sickness eases by around week

However, some women have really severe sickness, called hyperemesis gravidarum. This affects around % of pregnancies, and became well known when Kate Middleton, the Duchess of Cambridge, suffered from it when she was pregnant with Prince George. 

According to mynewextsetup.us, if your symptoms are, “persistent, severe and preventing daily activities” and typically last beyond week 20 of your pregnancy, you may need treatment with drugs. 

If you feel you’re not coping with pregnancy nausea, do talk to your midwife or doctor. 

There are also more serious sickness symptoms, which mean you should contact your GP or midwife immediately. These are:

  • if you’re unable to keep food or any fluids down for 24 hours
  • you don’t wee for more than 8 hours and your urine is dark coloured
  • you feel very weak, dizzy or faint when you stand up
  • you have stomach pains
  • you have a high temperature – 38°C (°F) or above
  • your sick contains blood

But aren’t anti-sickness drugs dangerous in pregnancy?    

In the 60s a drug called Thalidomide was used to treat morning sickness. This did prove to be dangerous to unborn babies and was banned from use to treat pregnancy sickness.

The medications doctors now prescribe are largely considered safe and effective, although as with all medicines there can be side effects and it’s generally best to avoid medication when you’re pregnant if you can.

One study of more than , women found babies born to mums who had taken an antihistamine during their pregnancy were no more likely to have something wrong with them than babies whose mothers had not taken one. And another study of 40, women proved that taking metoclopramide didn’t increase the risks birth defects or miscarriage.

How can I cope without taking medication?

There are also lots of ways to stop feeling and being sick that don’t involve a visit to the pharmacy.

“There are various things that you can try to reduce the symptoms before using drugs,” says Anne. “Try eating little and often. Also, acupressure bands, often used for travel sickness, can work wonders.”

Other suggested natural treatments include including more ginger in your diet, eating dry, bland foods first thing in the morning, acupuncture and wearing clothes that don’t feel tight around the waist. 

Mums writing in our forum say:

“I was given Prochlorperazine when I was 10 wks pregnant with my DD. I had suffered from about 5 weeks and lost almost a stone. I visited my GP every week and begged them to help me but it took until 10 weeks for them to prescribe them (they worked great once I got them). I had to take anti sickness tablets until I was 26wks.” baby_blaylock

“Have had really bad case of hyperemesis gravidarum since 6 weeks pregnant. Got medication from doctor but nothing seemed to really kick it but……last few days have become increasingly better and without jinxing myself I don’t feel sick today! Am hoping that this is the start of me turning a corner. Fingers crossed!” tiger

“I had Hyperemesis and lost 2 stone in a matter of weeks. Everyone kept saying it’s just morning sickness you have to force yourself to eat but I couldn’t even keep water down. When I saw my consultant my urine sample was neon orange and she said she’d never seen anything like it and wanted me on a drip now. I was put on medication and luckily it stopped me being sick but the nausea was there throughout the pregnancy. There are a lot of foods I still can’t eat because of it. There’s only so many times you can throw something up and still want to eat it.” Lucian3

Read more…

Источник: mynewextsetup.us

Severe pregnancy sickness: 'I thought I was dying'

By Georgie Bevan
BBC News

For Hannah Dalton, pregnancy meant not being able to drink fluids for eight months without throwing up, going into hospital 27 times for intravenous drips and living off ice lollies and anti-sickness medication.

Hannah, 30, from Thundersley, Essex, had hyperemesis gravidarum (HG), the severe pregnancy sickness the Duchess of Cambridge experienced during her three pregnancies.

She was bedridden for six months, ended up in a wheelchair and, at her worst, her body started to shut down.

"I seriously questioned was this still worth doing," Hannah says.

"We wanted a bigger family but was there a chance that we would lose me. I thought I was dying."

With support from her family, Hannah continued with her pregnancy and, in April, gave birth to a girl.

The moment she went into labour, the sickness stopped.

More than 5, women from across the UK have shared their experience of HG with BBC News:

  • Most had considered terminating their pregnancy
  • One in three had thought of killing themselves
  • About three-quarters were left with long-term physical and mental health problems, including post-traumatic stress disorder (PTSD) and depression
  • More than one in three said their experience with their GP had been "poor"

Last year, UK hospitals saw more than 36, admissions for pregnant women needing urgent care because of extreme sickness and dehydration.

The causes of HG are unknown. There is some evidence it runs in families. And if a woman had HG in a previous pregnancy, she is more likely to have it in the next.

Now, scientists at King's College London and Guy's and St Thomas' Hospital are launching a four-year study - the world's largest - in the hope of finding some answers.

Blood samples and medical histories will be taken from at least 1, women admitted to hospital with the most severe HG symptoms and others recruited via the charity Pregnancy Sickness Support.

The study will be looking for genetic links and hormonal changes, in particular a protein, GDF15, produced by the placenta, which affects the part of the brain controlling vomiting and nausea.

'Lifelong consequences'

Consultant obstetrician Prof Catherine Williamson says: "The problem we have is that the treatments aren't good enough.

"Our ambition is to identify genetic causes of this condition so we can tell why women have it and identify those at risk.

"We can then develop new treatments that are much more effective so hopefully there won't be any more women with severe hyperemesis, because we can control it."

What is hyperemesis gravidarum?

  • HG is very different from morning sickness, which affects about 80% of pregnant women
  • While morning sickness is unpleasant, women can usually continue with their daily lives and eat and drink normally
  • But those with HG can vomit more than 50 times a day and feel constantly and severely nauseous, significantly interfering with their daily lives
  • Complications can include serious vitamin deficiency from the excessive vomiting, significant weight loss, dehydration and malnutrition putting the health of both mother and baby at risk
  • It can often leave a woman bedridden for months, affecting her longer term mental and physical health
  • One in of all pregnant women is admitted to hospital because of severe sickness in pregnancy
  • The British Pregnancy Advisory Service (BPAS) estimates 10% of women with HG terminate their pregnancy
  • Before IV fluids were introduced, HG was the leading cause of death in early pregnancy
  • There is evidence to suggest Charlotte Bronte died of HG, in - her death certificate said tuberculosis but she was four months pregnant and had experienced severe nausea and vomiting

Ever since the thalidomide scandal 50 years ago, there has been concern about taking anti-sickness drugs during pregnancy.

The sedative, which was found to ease nausea and vomiting in expectant mothers, left thousands of babies with severe birth defects.

But most women with HG do end up taking some sort of medication to control the vomiting.

Only one, Xonvea, is permitted in Britain for use in pregnancy - but alternatives, such as cyclizine, prochlorperazine and ondansetron, are also regularly prescribed and considered safe by doctors who treat the condition.

Women may also be given vitamin B6 and B12 or steroids. If these don't work, women may need to be admitted to hospital for treatment including intravenous fluids.

Here are the words of one woman who terminated three pregnancies because of HG. She now has a young child.

"It's your own personal hell that you can't escape from. It's devastating. It completely takes over your life, your family's life, so it would be easier either to just miscarry or die.

"The vomiting and retching was so violent and so intense, I couldn't breathe.

"I couldn't take a breath while I was retching, so I passed out and woke up on the bathroom floor and I thought, 'Oh my God, I can't do this.'

'Ginger biscuits'

"I did have some dark moments.

"I wanted this baby so badly but I felt like it was killing me and ultimately, out of pure desperation, led me to have three terminations.

"I developed PTSD. I had insomnia and nightmares when I could sleep.

"The senior consultant came round and said, 'Have you tried ginger biscuits and salty crackers?' and I was like, 'Oh my God.'

"It's like saying to somebody with a broken leg, 'Have you tried rubbing lavender oil on it?' because if the senior consultant didn't understand, what hope did I have?"

Caitlin Dean, from Pregnancy Sickness Support, says not treating HG has serious risks.

"Increasingly evidence suggests that, while the actual nausea and vomiting is unlikely to harm the offspring, the complications of HG, such as malnutrition, dehydration and mental ill health, can cause lifelong consequences for both mother and baby," she says.

"There are many wonderful, compassionate doctors out there providing excellent evidence-based care for people with HG but unfortunately there are also doctors who do not recognise the condition, are reluctant to prescribe appropriate treatment or are unaware of the evidence base.

"This leads to a vast amount of unnecessary suffering, costly hospital admissions and, all too often, terminations of otherwise wanted pregnancies.

"In , there is very little excuse not to provide this basic level of care for pregnant women."

Felicity Collins, from Northamptonshire, was desperate for doctors to prescribe her stronger drugs to help her cope with HG.

She was already in hospital, and 24 hours away from terminating her twin pregnancy, when she was finally given steroids to ease the constant vomiting.

"It was such a dark time," she says.

"It was a decision we made because I knew without those drugs, I couldn't carry on.

"I couldn't eat or drink. Everything made me sick. It was so bad. That's how close it came."

For the next six months, she injected herself daily with steroids, finally giving birth to twin boys, Arthur and Harry, who are now three years old.

In eight weeks of pregnancy, Laura Anderson lost one stone (kg).

"I dream about eating again and drinking again," she says.

"This illness makes you a shadow of who you were… it's nine months of living hell."

Laura faces about 20 more weeks of HG before she gives birth.

She says: "I fully intend on getting to the end of this pregnancy with a baby, no matter what it does to my health.

"And when this baby girl is born and the HG has gone, I will spend the rest of my life trying to raise awareness about this awful illness.

"I'm doing it for my daughter, in case she gets it, and God forbid that she does."

More on this story

Related Internet Links

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Источник: mynewextsetup.us

Dr Rachel Ryan

Nausea and Vomiting in Pregnancy

Nausea and vomiting in pregnancy (known formally as hyperemesis gravidarum or, more commonly, as morning sickness) is very common, particularly in the first trimester.  For most women, this is certainly annoying, but relatively mild and manageable.  In most cases, symptoms begin to settle towards the end of the first trimester.

Some women, however, are not so lucky.  For some women symptoms continue until much later in the pregnancy (for some, they continue throughout the entire pregnancy) and some women can become quite dehydrated and start to lose weight.  Ideally, we want to avoid getting to the stage that you become dehydrated and start to lose weight.  This is not a great situation for the body to be in generally and, as you might imagine, not the best environment for a developing fetus.  If you are having trouble eating anything and are struggling to keep down fluids, you should contact me.

Here are some of the ways we can address nausea and vomiting in pregnancy, starting from the simplest measures and progressing up to the more intensive treatments.  Most people find they can manage their symptoms with a few of the more simple measures and very few people require the more full-on treatments.  Try to be proactive and contact me early if you think things are spiralling out of control.  The earlier we are able to treat you, the more likely we are to be able to use the simple methods only.

Simple lifestyle changes:

You may find that some activities make you vomit.  If you can, you should try to avoid these.  For example, if cooking meat makes you gag, see if someone else can take over that task until you’re feeling better.  If brushing your teeth makes you vomit, try rinsing with mouthwash instead – your teeth won't get quite as clean but this is OK in the short term (I’m not suggesting mouthwash as a longterm substitute for brushing and flossing!)

Try not to get too tired, as being tired will make your nausea worse.  Often, this is much easier said than done – but try not to pack too much into your evenings and weekends and take the opportunity to rest when you can.

Simple dietary measures:

Eat small meals frequently – letting yourself get really hungry may make you nauseated, as may large meals.  If you are on the go, it may help to carry some simple snacks with you, to nibble on from time to time.

Eat whatever you can manage – if all you can keep down is toast, then eat toast.  Don’t eat broccoli just because it’s good for you, if it makes you nauseated.

Have food and fluids separately – some people find that having a drink with a meal can make nausea worse so try separating your meals and your drinks.

Water is not the only fluid – if it makes you fell sick (some pregnant women find that they don’t like the ‘taste’ of water in the first trimester) try drinking fruit juice, sports drinks or cordial instead.  These drinks are all pretty sweet so you may want to dilute them.  Remember the important thing is to keep your fluids up – the kind of fluid you drink is less important.

Simple ‘remedies’:

Ginger – some women find ginger to be helpful.  This can be in the form of tablets, gingerale or ginger beer, cordials, tea, ginger flavoured sweets or ginger in the food you eat.  The evidence for ginger as a treatment is not great but it may work for you and, unless you really don’t like ginger, it’s probably worth a try.

Vitamin B6 – again the evidence is not great that this actually works but it may be worth a try.

Medication:

A variety of medication is available to help with morning sickness for women who need it.  Rest assured that I will not prescribe anything that is dangerous for your baby, so anything that I recommend for you will be quite safe.  If you get to the stage that you need medication, the best approach is to take it regularly until your symptoms are well under control and then to reduce the dose gradually.  Waiting until you are desperate and then using the smallest amount possible does not really work all that well.  Medications we may use include:

Metoclopramide (Maxolon, Pramin) – a simple anti-nausea medication taken anywhere from once to four times a day.  This medication has been used for a long time in pregnancy and has a long record of safety.  It can be given as a tablet or an intravenous or intramuscular injection.

Ondansetron (Zofran) – also safe in pregnancy, this medication is better at treating nausea than metoclopramide but has the disadvantage of being quite expensive.  It comes in wafer form for women who are too sick to swallow tablets and can also be given intravenously.

Sedating antihistamines – particularly useful at night

Corticosteroids – women with severe nausea and vomiting that hasn’t settled down with other treatments may improve with a shot course of steroids (not the same sort of steroids that body builders take) which are safe in pregnancy.

Intravenous fluids:

If other methods have failed and you are significantly dehydrated, we may need to arrange for you to be admitted for IV rehydration.  We can give IV anti nausea medication at the same time.  Some women may need to spend a few days in hospital.  For other women, it may be possible to come in two or three times a week as an outpatient for some IV fluids to help maintain adequate hydration (dehydration makes nausea worse).

So, you can see that there are lots of different options for treating nausea and vomiting in pregnancy, all of which are quite safe.  While mild nausea is common and self limiting, please contact me if your symptoms are more severe and we can work out a treatment plan that is appropriate for your situation.

Источник: mynewextsetup.us
1st trimester nausea medication

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1st trimester nausea medication -

Morning sickness relief - information and support

Pregnancy sickness – or morning sickness – is thought to be a reaction to high levels of pregnancy hormones, in particular human chorionic gonadotropin (hCG). These hormones rise quickly during the first few weeks of pregnancy.

Pregnancy sickness is often at its worst when you first wake up, which is why it is called morning sickness, but it can happen at any time of day.

For most women, the first 12 weeks are the worst. After that you should slowly start to feel better. By around weeks, you will probably find that the sickness has completely gone away.

Not every pregnant woman will get morning sickness. Pregnancy symptoms vary a lot, so don’t worry if you don’t have one of them.

Is there a cure for morning sickness?

No, there is no surefire way of stopping morning sickness. But there are some things that may give you some relief. These ideas have not been scientifically proven to work but they have helped some women, so you might like to try them out:

  • Eat little and often. Try eating six small meals a day instead of three big meals.
  • Rest. When you are tired the sickness can get worse.
  • Avoid foods with lots of sugar or saturated fats – such as sweets, chocolate and red meat.
  • Carbohydrates – things like bread, rice, potatoes and pasta – can be easier to eat when you’re feeling nauseous.
  • If possible, keep away from ‘triggers’ – food or smells that make you feel sick.
  • Have a small snack before getting up in the morning – something like dry toast or crackers.
  • Try foods or drinks that have ginger in them. You could try ginger biscuits, crystallised ginger or ginger herbal tea.
  • Try wearing acupressure bands throughout the day. You can buy elastic acupressure wristbands from most pharmacies. These bands have a plastic button that presses on the acupressure point on the wrist and it may help relieve the nausea.

What should I do if I get morning sickness at work?

This can be challenging, especially if you’re not ready to tell your colleagues about your pregnancy.

If you feel very ill it’s probably a good idea to tell your manager at work at work that you’re pregnant, but you don’t have to.

If you do decide to tell them about your pregnancy, this is a good time to talk about any changes to your work that might mynewextsetup.us example, you might need easier access to a toilet. Or if smells from the kitchen or canteen are triggering your sickness, maybe you could move somewhere else until you feel better.

Try not to worry too much about people knowing you are pregnant – it’s more important to look after yourself.

What if my morning sickness is really bad?

If you can’t keep any food or drink down, or you are worried at all about pregnancy sickness, see your midwife or doctor. You may have a condition called hyperemesis gravidarum.

What is hyperemesis gravidarum?

Hyperemesis gravidarumis a condition which causes excessive sickness and vomiting in pregnancy.

Symptoms of hyperemesis gravidarum

Other than severe nausea and sickness, you may also notice:

  • dark concentrated urine
  • weeing less often
  • feeling faint or dizzy
  • losing weight
  • blood in your vomit
  • a high temperature
  • low blood pressure.

If you are vomiting several times a day or are not able to eat and drink at all without being sick, you may be dehydrated, which is why you feel so bad.

Treating hyperemesis gravidarum

There are several medicines that are safe to use in pregnancy, including anti-sickness drugs (anti-emetics) or steroids. If you’re too sick to keep anything down, they can be given by injection.

You may also be prescribed a vitamin B supplement, which can help as well.

Hyperemesis can also affect how you feel emotionally and you may need some support with this.

If your sickness is really severe and you’re struggling to control it, you may need to go into hospital for treatment. This will usually be for a few days so the doctors can assess the condition and work out the best way to manage it for you and your baby.

Support for hyperemesis gravidarum (HG)

Источник: mynewextsetup.us

Dr Rachel Ryan

Nausea and Vomiting in Pregnancy

Nausea and vomiting in pregnancy (known formally as hyperemesis gravidarum or, more commonly, as morning sickness) is very common, particularly in the first trimester.  For most women, this is certainly annoying, but relatively mild and manageable.  In most cases, symptoms begin to settle towards the end of the first trimester.

Some women, however, are not so lucky.  For some women symptoms continue until much later in the pregnancy (for some, they continue throughout the entire pregnancy) and some women can become quite dehydrated and start to lose weight.  Ideally, we want to avoid getting to the stage that you become dehydrated and start to lose weight.  This is not a great situation for the body to be in generally and, as you might imagine, not the best environment for a developing fetus.  If you are having trouble eating anything and are struggling to keep down fluids, you should contact me.

Here are some of the ways we can address nausea and vomiting in pregnancy, starting from the simplest measures and progressing up to the more intensive treatments.  Most people find they can manage their symptoms with a few of the more simple measures and very few people require the more full-on treatments.  Try to be proactive and contact me early if you think things are spiralling out of control.  The earlier we are able to treat you, the more likely we are to be able to use the simple methods only.

Simple lifestyle changes:

You may find that some activities make you vomit.  If you can, you should try to avoid these.  For example, if cooking meat makes you gag, see if someone else can take over that task until you’re feeling better.  If brushing your teeth makes you vomit, try rinsing with mouthwash instead – your teeth won't get quite as clean but this is OK in the short term (I’m not suggesting mouthwash as a longterm substitute for brushing and flossing!)

Try not to get too tired, as being tired will make your nausea worse.  Often, this is much easier said than done – but try not to pack too much into your evenings and weekends and take the opportunity to rest when you can.

Simple dietary measures:

Eat small meals frequently – letting yourself get really hungry may make you nauseated, as may large meals.  If you are on the go, it may help to carry some simple snacks with you, to nibble on from time to time.

Eat whatever you can manage – if all you can keep down is toast, then eat toast.  Don’t eat broccoli just because it’s good for you, if it makes you nauseated.

Have food and fluids separately – some people find that having a drink with a meal can make nausea worse so try separating your meals and your drinks.

Water is not the only fluid – if it makes you fell sick (some pregnant women find that they don’t like the ‘taste’ of water in the first trimester) try drinking fruit juice, sports drinks or cordial instead.  These drinks are all pretty sweet so you may want to dilute them.  Remember the important thing is to keep your fluids up – the kind of fluid you drink is less important.

Simple ‘remedies’:

Ginger – some women find ginger to be helpful.  This can be in the form of tablets, gingerale or ginger beer, cordials, tea, ginger flavoured sweets or ginger in the food you eat.  The evidence for ginger as a treatment is not great but it may work for you and, unless you really don’t like ginger, it’s probably worth a try.

Vitamin B6 – again the evidence is not great that this actually works but it may be worth a try.

Medication:

A variety of medication is available to help with morning sickness for women who need it.  Rest assured that I will not prescribe anything that is dangerous for your baby, so anything that I recommend for you will be quite safe.  If you get to the stage that you need medication, the best approach is to take it regularly until your symptoms are well under control and then to reduce the dose gradually.  Waiting until you are desperate and then using the smallest amount possible does not really work all that well.  Medications we may use include:

Metoclopramide (Maxolon, Pramin) – a simple anti-nausea medication taken anywhere from once to four times a day.  This medication has been used for a long time in pregnancy and has a long record of safety.  It can be given as a tablet or an intravenous or intramuscular injection.

Ondansetron (Zofran) – also safe in pregnancy, this medication is better at treating nausea than metoclopramide but has the disadvantage of being quite expensive.  It comes in wafer form for women who are too sick to swallow tablets and can also be given intravenously.

Sedating antihistamines – particularly useful at night

Corticosteroids – women with severe nausea and vomiting that hasn’t settled down with other treatments may improve with a shot course of steroids (not the same sort of steroids that body builders take) which are safe in pregnancy.

Intravenous fluids:

If other methods have failed and you are significantly dehydrated, we may need to arrange for you to be admitted for IV rehydration.  We can give IV anti nausea medication at the same time.  Some women may need to spend a few days in hospital.  For other women, it may be possible to come in two or three times a week as an outpatient for some IV fluids to help maintain adequate hydration (dehydration makes nausea worse).

So, you can see that there are lots of different options for treating nausea and vomiting in pregnancy, all of which are quite safe.  While mild nausea is common and self limiting, please contact me if your symptoms are more severe and we can work out a treatment plan that is appropriate for your situation.

Источник: mynewextsetup.us

If you are pregnant or thinking of becoming pregnant, there’s no way to know for sure if you will suffer any morning sickness but your chances are pretty high. About 70 to 80 percent of women experience nausea in the first 12 weeks of pregnancy, and about 50 percent experience some vomiting. Some women never experience morning sickness, while others may feel sick throughout their entire pregnancy. You might have no morning sickness while pregnant with your first child and then not be as lucky with the next one. The key is to be prepared and know ahead of time how to best relieve morning sickness if it comes.

Here are some tips to relieve morning sickness:

Eat small meals instead of big meals.

Break up the portions and timing of your meals. Hormones produced during pregnancy, especially in the first trimester, slow down your digestive system muscles making it harder to digest larger meals. Eat smaller portions and eat more frequently throughout the day. Having an empty stomach or low blood sugar can cause nausea or make nausea worse. Eating small meals every few hours can keep your blood sugar steady and your stomach feeling full, but not too full. If you’re battling morning sickness, also stay away from spicy foods. You’ll want to eat foods you know are easy to digest.  

Drink before or after a meal, not during.

Staying hydrated is important, especially if you’re vomiting. Drink small amounts of fluid throughout the day, but limit fluid intake during meals to avoid feeling too full. Drink 30 minutes before or after a meal instead. If you prefer drinking with your meal, have a small glass of water rather than a beverage containing sugar, as too much sugar can upset your stomach.

Avoid cooking odors as much as possible.

If you can have someone else cook for you, that is ideal. If that’s not an option, ventilate your kitchen well while cooking. Open the windows, use the fan and, as long as nothing is cooking on the stovetop, leave the room to avoid inhaling cooking odors. Avoiding scents and odors in general is a good idea—perfumes, air fresheners, trash, etc.—especially when you’re not feeling well.

Avoid warm places.

Feeling hot can add to your nausea and make you feel even worse. Stay away from crowded, warm spaces that might overheat you or make you feel closed in. Cool air can bring relief, so seek air conditioning when heat and humidity is high or starts to bother you. Don’t wait until you’re overheated.  

Get as much rest as possible…but not right after eating.

Good news! Naps are recommended for pregnant women. Carrying a baby inside you takes energy and being sick saps that energy. Rest at intervals during the day, if you can. Take more frequent small breaks at work to change position, walk around and get fresh air. Also, do not lie down right after eating. Give your body time to digest the food first. Establish a good, calming pre-sleep routine at night to help you fall asleep more easily. Turn lights down and stay away from digital screens and devices an hour before your bedtime, if possible.

Keep ginger, lemons and watermelon handy.

While certain smells can make your nausea worse, sniffing certain fresh scents may help. Sniff fresh cut lemons or ginger for nausea relief. Drinking lemonade, ginger ale and eating watermelon works for many women as well. Ginger is proven to be effective in treating and preventing symptoms of morning sickness. Keep ginger candies on hand to help relieve nausea or make your own ginger tea. Peel and slice fresh ginger root, then add a 2-inch piece to boiling water. Let steep for 5 to 10 minutes, then strain into a cup. Sip or drink slowly to enjoy.

Take Dramamine®-N Multi-Purpose to relieve nausea.

Many people know the Dramamine® brand as a reliable remedy for motion sickness, but we also have a formula made to relieve the type of nausea and vomiting that comes with morning sickness during pregnancy. Dramamine®-N Multi-Purpose Formula is formulated with ginger extract to naturally relieve nausea and is safe for pregnant women.

Easily find where to buy Dramamine®-N  and check our Special Offers page for money-saving coupons. 

When to call your doctor

If you’re experiencing morning sickness, you should tell your doctors. They will want to keep tabs on how severe it is and how long it lasts into your pregnancy. If you experience severe morning sickness—excessive nausea and vomiting—where you are unable to eat or drink, or if you have pain and fever with vomiting, call your doctor as soon as possible.

Relieve morning sickness with Dramamine®

Источник: mynewextsetup.us

Diagnosis

Management

Prescribing information

Background information

Nausea/vomiting in pregnancy: Summary

  • The majority of women vomit or feel nauseated in early pregnancy. Symptoms usually begin between the fourth and seventh weeks of gestation and usually resolve around the 20th week of pregnancy.
  • Hyperemesis gravidarum is a diagnosis of exclusion characterized by prolonged and severe nausea and vomiting, dehydration, electrolyte imbalance, ketonuria, and body weight loss of more than 5% of pre-pregnancy weight.
  • Findings which may suggest an alternative diagnosis include:
    • Onset of symptoms after 11 weeks of gestation.
    • Abdominal pain or tenderness (more than mild epigastric tenderness after retching). 
    • Fever. 
    • Headache or abnormal neurological examination.
    • Goitre.
  • Complications are more likely in women with severe vomiting and include:
    • Maternal — weight loss, dehydration, hyponatraemia, vitamin deficiencies, Mallory-Weiss tear or oesophageal rupture, increased risk of venous thromboembolism.
    • Fetal — possible higher incidence of low birthweight babies (if hyperemesis gravidarum).
  • Laboratory investigations are not required in uncomplicated cases, but a minority of women, for whom symptoms are more severe, will require further assessment.
  • Management includes:
    • Asking about the nausea and vomiting (for example onset, duration, frequency, effect of food, associated symptoms, co-existing conditions, and effect of mood and quality of life).
    • If nausea or vomiting is affecting fluid and food intake, monitoring weight, checking for dehydration, testing the urine for ketones, and referring for pelvic ultrasound to assess for predisposing multiple or molar pregnancy.
    • Offering appropriate self-care advice (for example rest, adequate fluid intake, and small frequent meals). Some women find ginger or acupressure helps symptoms.
    • Considering the need for an oral anti-emetic if self-care advice fails and the woman has persistent symptoms. 
  • Hospital admission should be considered if the woman has:
    • Continued nausea and vomiting and is unable to keep down liquids or oral antiemetics.
    • Continued nausea and vomiting with ketonuria and/or weight loss (greater than 5% of body weight), despite treatment with oral antiemetics.
    • A confirmed or suspected comorbidity (for example she is unable to tolerate oral antibiotics for a urinary tract infection).
  • The threshold for admitting to hospital or seeking specialist advice should be lower for women with co-existing conditions (for example diabetes).
  • Admission or specialist advice may also be required if there is suspicion of an alternative diagnosis or complications requiring specialist management. 
Источник: mynewextsetup.us

Severe pregnancy sickness: 'I thought I was dying'

By Georgie Bevan
BBC News

For Hannah Dalton, pregnancy meant not being able to drink fluids for eight months without throwing up, going into hospital 27 times for intravenous drips and living off ice lollies and anti-sickness medication.

Hannah, 30, from Thundersley, Essex, had hyperemesis gravidarum (HG), the severe pregnancy sickness the Duchess of Cambridge experienced during her three pregnancies.

She was bedridden for six months, ended up in a wheelchair and, at her worst, her body started to shut down.

"I seriously questioned was this still worth doing," Hannah says.

"We wanted a bigger family but was there a chance that we would lose me. I thought I was dying."

With support from her family, Hannah continued with her pregnancy and, in April, gave birth to a girl.

The moment she went into labour, the sickness stopped.

More than 5, women from across the UK have shared their experience of HG with BBC News:

  • Most had considered terminating their pregnancy
  • One in three had thought of killing themselves
  • About three-quarters were left with long-term physical and mental health problems, including post-traumatic stress disorder (PTSD) and depression
  • More than one in three said their experience with their GP had been "poor"

Last year, UK hospitals saw more than 36, admissions for pregnant women needing urgent care because of extreme sickness and dehydration.

The causes of HG are unknown. There is some evidence it runs in families. And if a woman had HG in a previous pregnancy, she is more likely to have it in the next.

Now, scientists at King's College London and Guy's and St Thomas' Hospital are launching a four-year study - the world's largest - in the hope of finding some answers.

Blood samples and medical histories will be taken from at least 1, women admitted to hospital with the most severe HG symptoms and others recruited via the charity Pregnancy Sickness Support.

The study will be looking for genetic links and hormonal changes, in particular a protein, GDF15, produced by the placenta, which affects the part of the brain controlling vomiting and nausea.

'Lifelong consequences'

Consultant obstetrician Prof Catherine Williamson says: "The problem we have is that the treatments aren't good enough.

"Our ambition is to identify genetic causes of this condition so we can tell why women have it and identify those at risk.

"We can then develop new treatments that are much more effective so hopefully there won't be any more women with severe hyperemesis, because we can control it."

What is hyperemesis gravidarum?

  • HG is very different from morning sickness, which affects about 80% of pregnant women
  • While morning sickness is unpleasant, women can usually continue with their daily lives and eat and drink normally
  • But those with HG can vomit more than 50 times a day and feel constantly and severely nauseous, significantly interfering with their daily lives
  • Complications can include serious vitamin deficiency from the excessive vomiting, significant weight loss, dehydration and malnutrition putting the health of both mother and baby at risk
  • It can often leave a woman bedridden for months, affecting her longer term mental and physical health
  • One in of all pregnant women is admitted to hospital because of severe sickness in pregnancy
  • The British Pregnancy Advisory Service (BPAS) estimates 10% of women with HG terminate their pregnancy
  • Before IV fluids were introduced, HG was the leading cause of death in early pregnancy
  • There is evidence to suggest Charlotte Bronte died of HG, in - her death certificate said tuberculosis but she was four months pregnant and had experienced severe nausea and vomiting

Ever since the thalidomide scandal 50 years ago, there has been concern about taking anti-sickness drugs during pregnancy.

The sedative, which was found to ease nausea and vomiting in expectant mothers, left thousands of babies with severe birth defects.

But most women with HG do end up taking some sort of medication to control the vomiting.

Only one, Xonvea, is permitted in Britain for use in pregnancy - but alternatives, such as cyclizine, prochlorperazine and ondansetron, are also regularly prescribed and considered safe by doctors who treat the condition.

Women may also be given vitamin B6 and B12 or steroids. If these don't work, women may need to be admitted to hospital for treatment including intravenous fluids.

Here are the words of one woman who terminated three pregnancies because of HG. She now has a young child.

"It's your own personal hell that you can't escape from. It's devastating. It completely takes over your life, your family's life, so it would be easier either to just miscarry or die.

"The vomiting and retching was so violent and so intense, I couldn't breathe.

"I couldn't take a breath while I was retching, so I passed out and woke up on the bathroom floor and I thought, 'Oh my God, I can't do this.'

'Ginger biscuits'

"I did have some dark moments.

"I wanted this baby so badly but I felt like it was killing me and ultimately, out of pure desperation, led me to have three terminations.

"I developed PTSD. I had insomnia and nightmares when I could sleep.

"The senior consultant came round and said, 'Have you tried ginger biscuits and salty crackers?' and I was like, 'Oh my God.'

"It's like saying to somebody with a broken leg, 'Have you tried rubbing lavender oil on it?' because if the senior consultant didn't understand, what hope did I have?"

Caitlin Dean, from Pregnancy Sickness Support, says not treating HG has serious risks.

"Increasingly evidence suggests that, while the actual nausea and vomiting is unlikely to harm the offspring, the complications of HG, such as malnutrition, dehydration and mental ill health, can cause lifelong consequences for both mother and baby," she says.

"There are many wonderful, compassionate doctors out there providing excellent evidence-based care for people with HG but unfortunately there are also doctors who do not recognise the condition, are reluctant to prescribe appropriate treatment or are unaware of the evidence base.

"This leads to a vast amount of unnecessary suffering, costly hospital admissions and, all too often, terminations of otherwise wanted pregnancies.

"In , there is very little excuse not to provide this basic level of care for pregnant women."

Felicity Collins, from Northamptonshire, was desperate for doctors to prescribe her stronger drugs to help her cope with HG.

She was already in hospital, and 24 hours away from terminating her twin pregnancy, when she was finally given steroids to ease the constant vomiting.

"It was such a dark time," she says.

"It was a decision we made because I knew without those drugs, I couldn't carry on.

"I couldn't eat or drink. Everything made me sick. It was so bad. That's how close it came."

For the next six months, she injected herself daily with steroids, finally giving birth to twin boys, Arthur and Harry, who are now three years old.

In eight weeks of pregnancy, Laura Anderson lost one stone (kg).

"I dream about eating again and drinking again," she says.

"This illness makes you a shadow of who you were… it's nine months of living hell."

Laura faces about 20 more weeks of HG before she gives birth.

She says: "I fully intend on getting to the end of this pregnancy with a baby, no matter what it does to my health.

"And when this baby girl is born and the HG has gone, I will spend the rest of my life trying to raise awareness about this awful illness.

"I'm doing it for my daughter, in case she gets it, and God forbid that she does."

More on this story

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Источник: mynewextsetup.us

Is it safe to take anti-sickness medication when pregnant?

In a nutshell

Most anti-sickness (anti-emetic) medication is safe to take during pregnancy but a doctor should always prescribe anti-emetic drugs, and it’s worth trying natural alternatives first.

The expert view

If you’re really struggling with sickness during your pregnancy, there’s good news: anti-sickness medications are safe to take during pregnancy if prescribed by a doctor. Anti-sickness drugs have had a difficult history – see more below – but rest assured, there is medicine you can take which won’t harm your baby.

“There is medication that is safe to use in pregnancy,” confirms midwife Anne Richley, “but it should always be prescribed by a doctor, not bought over the counter.”

The NHS commonly prescribes antihistamines like Promethazine and Cyclizine to treat pregnancy sickness and taking anti-emetic drugs, like Prochlorperazine (Stemetil) or Metoclopramide, is another way of easing pregnancy nausea.

These drugs work either by blocking the signals from and to your the part of your brain that controls the sickness mechanism, or by encouraging your stomach to empty faster, so there’s nothing to bring up. You may also be prescribed vitamin B6, which may help relieve pregnancy nausea for some women, though it doesn’t reduce vomiting.

So when might you need to take anti-sickness drugs?

While more than half of pregnant women suffer with morning sickness, most mums-to-be are able to get through it and find the sickness eases by around week

However, some women have really severe sickness, called hyperemesis gravidarum. This affects around % of pregnancies, and became well known when Kate Middleton, the Duchess of Cambridge, suffered from it when she was pregnant with Prince George. 

According to mynewextsetup.us, if your symptoms are, “persistent, severe and preventing daily activities” and typically last beyond week 20 of your pregnancy, you may need treatment with drugs. 

If you feel you’re not coping with pregnancy nausea, do talk to your midwife or doctor. 

There are also more serious sickness symptoms, which mean you should contact your GP or midwife immediately. These are:

  • if you’re unable to keep food or any fluids down for 24 hours
  • you don’t wee for more than 8 hours and your urine is dark coloured
  • you feel very weak, dizzy or faint when you stand up
  • you have stomach pains
  • you have a high temperature – 38°C (°F) or above
  • your sick contains blood

But aren’t anti-sickness drugs dangerous in pregnancy?    

In the 60s a drug called Thalidomide was used to treat morning sickness. This did prove to be dangerous to unborn babies and was banned from use to treat pregnancy sickness.

The medications doctors now prescribe are largely considered safe and effective, although as with all medicines there can be side effects and it’s generally best to avoid medication when you’re pregnant if you can.

One study of more than , women found babies born to mums who had taken an antihistamine during their pregnancy were no more likely to have something wrong with them than babies whose mothers had not taken one. And another study of 40, women proved that taking metoclopramide didn’t increase the risks birth defects or miscarriage.

How can I cope without taking medication?

There are also lots of ways to stop feeling and being sick that don’t involve a visit to the pharmacy.

“There are various things that you can try to reduce the symptoms before using drugs,” says Anne. “Try eating little and often. Also, acupressure bands, often used for travel sickness, can work wonders.”

Other suggested natural treatments include including more ginger in your diet, eating dry, bland foods first thing in the morning, acupuncture and wearing clothes that don’t feel tight around the waist. 

Mums writing in our forum say:

“I was given Prochlorperazine when I was 10 wks pregnant with my DD. I had suffered from about 5 weeks and lost almost a stone. I visited my GP every week and begged them to help me but it took until 10 weeks for them to prescribe them (they worked great once I got them). I had to take anti sickness tablets until I was 26wks.” baby_blaylock

“Have had really bad case of hyperemesis gravidarum since 6 weeks pregnant. Got medication from doctor but nothing seemed to really kick it but……last few days have become increasingly better and without jinxing myself I don’t feel sick today! Am hoping that this is the start of me turning a corner. Fingers crossed!” tiger

“I had Hyperemesis and lost 2 stone in a matter of weeks. Everyone kept saying it’s just morning sickness you have to force yourself to eat but I couldn’t even keep water down. When I saw my consultant my urine sample was neon orange and she said she’d never seen anything like it and wanted me on a drip now. I was put on medication and luckily it stopped me being sick but the nausea was there throughout the pregnancy. There are a lot of foods I still can’t eat because of it. There’s only so many times you can throw something up and still want to eat it.” Lucian3

Read more…

Источник: mynewextsetup.us

Comments

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