Almost every second woman is exposed to toxicosis during pregnancy. Basically, toxicosis is accompanied by nausea, dizziness and vomiting. Such symptoms haunt a woman most often in the first trimester and seriously complicate life, but it is still possible to get rid of them, if not completely, then to significantly reduce the manifestations of toxicosis. It must be remembered that each woman requires an individual approach and, first of all, it is necessary to understand what toxicosis is.

Development of toxicosis

Why do some women develop toxicosis, while others do not, and what is the reason for this? Even qualified specialists cannot give a definite answer to this question. Some scientists are inclined to think that the manifestation of toxicosis is a hereditary predisposition and is associated with certain hormones. In general, toxicosis is caused by hormonal imbalances, changes in physiological characteristics in a woman’s body during pregnancy, as well as immunological changes and stress on the central nervous system.

It is changes in the nervous system that have a noticeable effect on the functioning of the gastrointestinal tract, which manifests itself in the form of nausea and vomiting during pregnancy, as well as increased salivation. Some chronic diseases in women associated with the stomach and intestines can intensify all manifestations of toxicosis in the early stages of pregnancy. It is believed that toxicosis is a kind of natural way to protect the fetus from exposure to harmful and unnecessary products.

Three degrees of toxicosis

Toxicosis occurs in all women with some differences. There are three degrees of toxicosis that accompany pregnancy - mild, moderate and severe. Mild symptoms include nausea and sometimes vomiting after meals and in the morning, generally no more than 3-5 times a day. There is a decrease in appetite, which sometimes leads to a slight weight loss, up to 3 kg, as well as a general depressed state. In such cases, a special diet is prescribed. Avoid foods that cause nausea and vomiting. In addition, the doctor may prescribe sedatives that reduce excessive excitability of the nervous system and medications that remove toxic substances from the body.

The average degree is characterized by increased attacks of nausea and vomiting, the number of which increases up to ten times a day. Appetite worsens, significant weight loss is possible, and the woman’s depressed psychological state is noted. In some cases, vomiting occurs once a day, but nausea and the urge to vomit begin at the sight and smell of any food. In such cases, it is necessary to consult a doctor who will prescribe the correct treatment. If the average severity of toxicosis lasts for a long time, infusion therapy may be necessary to replenish the lack of fluid and nutrients in the woman’s body.

In case of severe toxicosis, which is accompanied by frequent vomiting and complete refusal to eat, urgent hospitalization is necessary. In such cases, the pregnant woman cannot even drink water, which leads to rapid dehydration of the body, metabolic disorders and a significant deterioration in overall well-being. In cases where treatment does not produce any results, this may be a reason to terminate the pregnancy.

Timely prevention

It is worth noting that frequent and quite severe vomiting in pregnant women occurs much less frequently if you consult a doctor in time, who will suggest the correct treatment. You can significantly alleviate the symptoms of toxicosis if you properly balance your diet, eliminate foods that cause irritation, do special exercises, spend more time in the fresh air and follow all the recommendations of a specialist. In many cases, compliance with all these aspects helps to completely get rid of vomiting, and sometimes even nausea. Particular attention should be paid to walks outside, preferably in a park, as the body receives a sufficient amount of oxygen, which has a positive effect on all internal processes in a woman’s body. In addition, blood circulation improves during such walks, which is also necessary for the full functioning of all systems during pregnancy.

Very often, morning nausea and vomiting is caused by a sudden change in body position, and therefore you should avoid jumping out of bed quickly. After waking up, you need to stay in bed for some time so that the body gradually transitions to a state of wakefulness. If, while in bed, a woman still experiences attacks of nausea, she needs to eat at least a small amount of a carbohydrate product, for example, a piece of black bread or a cracker. This will help cope with nausea and prevent vomiting. Warm herbal teas help well; chamomile tea has a beneficial effect on digestion, is an anti-inflammatory product and relieves nausea. Some women find that acidic foods such as lemon, apple and kiwi, which are also rich in trace elements, vitamins and nutrients, help relieve nausea.

You need to take your diet seriously and limit your consumption of large amounts of fatty, spicy and smoked foods. Eat more plant foods, vegetables, berries, fruits, as well as porridge; they are very nutritious and beneficial both for the health of the mother and for the full development of the baby. It is best to eat in small portions, but often. In addition, it is important to remember that food that is too hot or cold is a strong irritant to the stomach.

Basically, when vomiting, acidic foods accumulate in the body, and therefore it is better to drink alkaline drinks, this will help reduce or completely eliminate the feeling of nausea and vomiting. It is recommended to drink more mineral water, preferably still, and be sure to add a small amount of fresh lemon to your tea. When vomiting, tea made from mint or lemon balm has a beneficial effect on the body, as well as valerian, which is brewed as tea, it helps relieve excessive nervous tension and improves night sleep. Drinking, like food, should not be too cold or hot, as this will irritate the walls of the stomach.

Specially designed gymnastics for pregnant women helps eliminate frequent attacks of nausea and vomiting. Exercises aimed at improving breathing and stretching muscles are recommended. In general, during physical exercise, blood circulation improves, all cells of the body are saturated with oxygen, which affects the full functioning of all systems in a woman’s body.

How to relieve attacks of toxicosis?

In addition to a balanced diet, taking vitamins, herbal soothing teas and exercises, there are several methods that our great-grandmothers used to alleviate toxicosis during pregnancy - infusions and decoctions of natural medicinal herbs. Doctors note that such decoctions have a positive effect on the entire body as a whole, as it has anti-inflammatory and soothing properties.

To normalize the functioning of the gastrointestinal tract and eliminate the occurrence of nausea and vomiting, you can prepare the following decoction. To prepare it you will need wormwood – 8 parts, yarrow – 2 parts and St. John’s wort – 2 parts. It is necessary to grind the ingredients and mix together. One tablespoon of the resulting mixture is poured into a glass of boiling water and left in a sealed container for fifteen minutes. You need to take this decoction 3 times a day before meals, 1/3 cup.

To relieve irritability and nausea, as well as improve overall well-being and normalize sleep, this medicinal mixture is suitable. It is necessary to take chamomile flowers, valerian root, fennel and caraway fruits and mint leaves in equal proportions, chop all this and mix thoroughly. A tablespoon of the mixture already obtained is poured with one glass of boiling water and left for about 20-30 minutes. You need to drink this decoction at night before going to bed, ½ cup.

To prevent morning sickness, it is recommended to use peppermint essential oil. A few drops of oil can be placed directly on your pillow before going to bed or on a handkerchief that you leave at your head.

Vomiting during pregnancy

Pregnancy makes every woman truly beautiful. At the same time, it brings a lot of anxiety and ailments. Half of expectant mothers experience nausea and vomiting. This is one of the very first signs of toxicosis in pregnant women. Vomiting may appear as a manifestation of early toxicosis, due to any diseases or due to a functional disorder of the gastrointestinal tract.

Vomiting in early pregnancy

Most often, vomiting occurs after attacks of nausea due to heartburn, poor appetite and increased sensitivity to odors. These symptoms appear already in the fifth or sixth week of pregnancy. Morning deterioration of health appears after sudden movements, eating and strong odors. Severe, constant vomiting leads to dehydration, weight loss and deterioration in general condition. Treatment is prescribed if vomiting occurs more than five times during the day.

Vomiting in late pregnancy

In late pregnancy, vomiting occurs unexpectedly despite feeling well. The cause is food that your stomach does not accept. During pregnancy it is most sensitive. This is how nature tries to protect your baby. The cause may also be overeating, when the enlarged uterus puts pressure on the stomach. Many women experience problems with their intestines and stomach before giving birth. The body tries to get rid of everything unnecessary before difficult work. Treatment in such cases is rarely prescribed. First of all, you need to adjust your diet, eat small portions, sleep on an elevation using the knee-elbow position. If you feel unexpectedly bad in the last month, this may indicate the onset of labor.

Vomiting during pregnancy, what to do?

Very often, an unpleasant condition can be alleviated by changing daily habits. In the morning, before getting up in bed, eat a cracker or cookie and drink a few sips of water. Get out of bed after a while. It is better to rest in a semi-sitting position, raising your upper body.

Drink enough liquid and do not starve, eat small meals. Avoid spicy, fatty and smoked foods. For snacks, choose fruits, vegetables and light fermented milk drinks. For breakfast, eat egg whites and boiled meat. Vitamin B6 helps eliminate nausea and prevent vomiting. It is found in cabbage, carrots, walnuts, wheat, potatoes, and bananas. The first courses are also healthy - light broths and soups. Warm and liquid food is well accepted by the stomach. If drinking causes vomiting, try sucking on ice and drinking small sips between meals, not during. Mineral water or tea with ginger helps many. You can cut a lemon and inhale its aroma. This is good for eliminating nausea and vomiting.

Take more walks in the fresh air. This helps enrich the blood with oxygen and has a beneficial effect on the health of the expectant mother and baby. Take the necessary vitamin and mineral complexes. They replenish the deficiency of essential microelements that leave the body during vomiting. Avoid unpleasant odors that make you feel uncomfortable.

Vomiting of bile during pregnancy

Vomiting of bile during pregnancy occurs when it is very frequent, or reflux of contents into the duodenum and stomach occurs. This is called duodeno-gastric reflux. The appearance of bile is a very alarming symptom. This also happens on an empty stomach, so when you wake up, be sure to eat something and drink a little water. If bile appears in the vomit, you need to urgently call an ambulance.

Vomiting blood during pregnancy

The appearance of blood in vomit during pregnancy indicates Melory-Weiss syndrome. If this happens repeatedly, then gagging contributes to the appearance of cracks in the mucous membrane of the stomach where it passes into the esophagus. This is very dangerous for a pregnant woman. The presence of blood may indicate a stomach ulcer or varicose veins of the esophagus.

Diarrhea and vomiting during pregnancy

The appearance of diarrhea along with nausea and vomiting occurs due to intestinal infections. These are dysentery, salmonellosis, exacerbation of gastroenteritis. They are accompanied by an increase in body temperature. This is extremely dangerous, so you need to urgently call a doctor.

Severe vomiting during pregnancy

If a pregnant woman takes good care of herself and follows the necessary regimen, then vomiting is very rare. This is a serious disease that leads to disruption of important systems and organs. An imbalance occurs in carbohydrate, salt and fat metabolism. Hypovitaminosis appears, the accumulation of toxins in the body, changes in metabolism and metabolic acidosis appear. Changes in the kidneys, liver and other organs are possible. The woman feels unwell, has a loss of strength, increased irritability and headaches. With frequent attacks, more than twenty times a day, not only water, but also food leaves the body. This is accompanied by increased salivation, which significantly aggravates the condition and leads to weight loss. The skin becomes flabby and dry, the breath smells unpleasant of acetone, and a coating is visible on the tongue. The abdomen is painful on palpation. Tachycardia occurs, and an increase in body temperature to 38 ° C is observed. Protein appears in the urine, and a blood test shows an increase in nitrogen and bilirubin. The sclera may be yellow due to liver problems. If the necessary measures are not taken in time, then with an increase in intoxication and dystrophy, there is a possibility of coma and death. The following symptoms give a severe prognosis:

• prolonged tachycardia;
• disorders of the nervous system;
• increased body temperature;
• jaundice.

Treatment is carried out in a hospital and includes a set of measures:

• restoration of the nervous system;
• normalization of water balance and nutrition;
• treatment of concomitant diseases;
• restoration of the metabolic process in the body.

Conditions for a favorable emotional background and peace are created for the pregnant woman. It is necessary to wait for complete recovery so that vomiting does not resume again. Methods of psychotherapy and hypnosis are successfully used. Food is taken lying down and in small portions. It should be enriched with vitamins and well absorbed.

This phenomenon occurs in 50–60% of pregnancies. Vomiting during pregnancy does not happen every day and does not affect the condition of the pregnant woman. The periodic occurrence of vomiting attacks is not considered toxicosis, and pregnant women do not need therapy.

Symptoms of vomiting in pregnant women and its degree

The occurrence of vomiting during pregnancy is possible every day, which leads to physical and psychological exhaustion of the woman. Toxicoses of pregnant women include vomiting, which occurs not only in the morning, but is repeated several times a day, even after eating. Vomiting during pregnancy is accompanied by nausea, decreased appetite, and changes in taste and olfactory sensations.

First degree of severity of vomiting in pregnant women

Depending on the severity, there are three degrees of vomiting during pregnancy.

First degree– slight vomiting. There are changes in the pregnant woman's body, which amount to minor changes in the nervous system. There is a decrease in the activity of nervous processes in the cerebral cortex, an increase in the excitability of subcortical centers, dysfunction of the autonomic nervous system, severe metabolic disorders and the functions of other organs and systems.

Symptoms of this severity are manifested by the presence of vomiting 2–4 times a day, mainly after meals. However, some of the food is retained, and no significant weight loss is observed. Usually there is no violation of the general condition:

the temperature remains normal,

The pulse is slightly increased (up to 90 per minute),

blood pressure is normal.

There are frequent complaints of frequent mood swings, drowsiness, and general loss of energy.

Diuresis remains the same.

As a rule, attacks of vomiting last no more than 2–3 months of pregnancy, are easily treated or even go away spontaneously. However, 10–15% of pregnant women experience increased vomiting and a transition to the next degree of severity.

Signs of moderate vomiting during pregnancy

Second degree– average vomiting of pregnant women. It is typical for her

• increased changes in nervous system function,
• increase in the degree of autonomic disorders,
• disorders appear in carbohydrate and fat metabolism, which leads to the development of ketoacidosis.

Sometimes changes appear in the activity of the endocrine glands - the pituitary gland, the adrenal cortex, the corpus luteum, etc., which leads to the progression of further metabolic disorders.

Symptoms of this severity are characterized by increased attacks of vomiting (up to 10 times or more per day), occurring regardless of food intake. Vomiting is often accompanied by drooling, which can reach a significant degree. A pregnant woman is losing weight. Body temperature often rises (up to 37.5 ºС), pulse lability with a tendency to tachycardia (90–100 per minute), significant weakness and apathy are noted. Diuresis decreases, and sometimes transient acetonuria appears. When testing urine for acetone, a positive reaction is revealed (+, ++ and less often +++). The tongue is coated, dry, and there may be constipation.

When examining blood, there are usually no significant changes; there may only be a slight decrease in the number of red blood cells and hemoglobin, as well as a decrease in chloride content. With timely and adequate treatment in a hospital setting, as a rule, there is a decrease in all clinical symptoms, and disorders of the nervous, endocrine and other systems gradually disappear. In rare cases, relapses of vomiting occur, requiring repeated courses of treatment. Subsequently, after the symptoms of toxicosis are relieved, pregnancy proceeds normally. Quite rarely, moderate vomiting during pregnancy progresses to an even more severe stage - excessive vomiting.

Symptoms of third-degree vomiting in pregnant women

Third degree– excessive vomiting. It is a more serious disease, characterized by serious dysfunction of the most important systems and organs. With this form of toxicosis, vomiting is one of many symptoms, the occurrence of which is associated with significant dysfunction of the nervous system, endocrine glands, liver, kidneys and other organs.

In such cases, not only carbohydrate and fat metabolism is disrupted, but also mineral metabolism.

As a result, hypovitaminosis occurs, the accumulation of toxic products of impaired metabolism, the acid-base state changes, and metabolic acidosis occurs.

Dystrophic changes in the liver, kidneys, etc. are often observed.

With this form, a severe general condition, loss of strength, weakness, sometimes excessive irritability and tearfulness, headache, and a sharp aversion to food are noted.

Vomiting up to 20 times or more per day occurs not only during the day, but also at night; not only food, but also water is not retained.

Often, attacks of vomiting are accompanied by drooling.

Severe complications of vomiting in pregnant women

If the treatment is ineffective, severe exhaustion is observed, body weight decreases and the subcutaneous fat layer disappears. The skin becomes dry and flabby, the tongue is covered with a whitish coating, the smell of acetone is noted from the mouth, and dry mucous membranes are observed. The abdomen is sunken, sometimes painful on palpation. The body temperature is subfebrile, but can rise to 38 ºС and higher, severe tachycardia (100–120 per minute) and hypotension occur.

Daily diuresis is reduced, acetone is found in the urine, and protein and casts often appear. A urine test for acetone reveals a clearly positive reaction (+++ or ++++).

There are changes in the blood:

• the content of residual nitrogen increases,
• the amount of chlorides decreases,
• The amount of bilirubin often increases.

Due to dehydration, hemoglobin increases. Liver damage is manifested by yellow discoloration of the skin. The ineffectiveness of the treatment leads to a deterioration of all clinical signs up to the development of coma and death, to avoid which resuscitation and intensive treatment measures are taken.

As a rule, diagnosing all of the above forms of flow does not cause difficulties. The only important point is to exclude other pathologies that cause attacks of vomiting (infectious diseases, intoxication, diseases of the stomach, brain, etc.).

Features of the treatment of vomiting in pregnant women

In most cases, treatment of vomiting in pregnant women is carried out in a hospital, with the exception of mild forms, which can be treated in a day hospital and on an outpatient basis. Complex therapy is used that affects

• on the nervous system
• to combat hunger and weight loss,
• dehydration and metabolic disorders.

Treatment of concomitant diseases is also important.

Normalization of the nervous system in the treatment of vomiting in pregnant women

During treatment in a hospital, conditions of emotional and physical peace are created, which sometimes leads to the cessation of vomiting without additional treatment. Vomiting may resume when the patient is discharged prematurely. Have a huge impact

• good care
• silence,
• long sleep,
• convincing conversations and explaining to the woman that vomiting usually goes away without a trace, and the pregnancy develops normally.

Also, to normalize the central nervous system, sedatives (usually of plant origin - valerian, motherwort), psychotherapy, electrosleep and electroanalgesia are used. A good effect was noted from various options of reflexology, oxybarotherapy, endonasal electrophoresis with vitamin B.

Drug treatments for vomiting during pregnancy

Methods of influencing the nervous system also include treating vomiting in pregnant women with sodium bromide and caffeine. The use of these drugs helps restore impaired cortical dynamics and relationships between the cortex and subcortex. When vomiting, sodium bromide is administered in the form of microenemas (30–50 ml of solution once a day), 10% Caffeine is administered subcutaneously 1 ml. If it is possible to retain food, caffeine can be administered orally (0.1 g 1–2 times a day). Sometimes stronger drugs are used - tranquilizers (aminazine), etc.

Also in the fight against vomiting can be used: Propazine (0.025 g orally 1-2 times a day), Droperidol (if there is an anesthesiologist in the hospital), intravenous administration of Novocaine, Calcium Chloride, vitamins (C, B), etc. However, all antiemetics should be used with great caution to avoid adverse effects on pregnancy.

Combating dehydration and starvation during vomiting in pregnant women

An important point in treatment is the fight against dehydration and starvation. For this purpose, I use infusion therapy in an amount of 2–2.5 liters per day. Ringer-Locke solution (daily 1000–1500), 5% Glucose (500–1000 ml), 5% Ascorbic acid (5 ml) and insulin (1 IU per 4.0 g of dry matter Glucose) are administered. Drip enemas from an isotonic solution of sodium chloride with Glucose (100 ml of 40% Glucose solution per 1 liter of isotonic solution) are used quite widely, as they protect against dehydration and promote the absorption of nutrients.

With the help of such enemas, it is possible to administer 1.5–2 liters of liquid. Also, if a patient is vomiting, it is recommended to take light, varied and easily digestible foods rich in vitamins. When choosing dishes, you must definitely take into account the wishes of the pregnant woman herself. The patient should eat food lying down, in small portions.

If signs of metabolic acidosis appear, it is recommended to administer sodium bicarbonate intravenously (100–150 ml of a 5% solution) or in the form of enemas.

In case of significant depletion, they resort to blood transfusion (80–10 ml of same-group blood), and centered solutions of dry plasma are administered.

The effectiveness of treatment for vomiting in a pregnant woman is judged by the improvement in the general condition of the pregnant woman and the results of blood and urine tests.

Indications for termination of pregnancy in case of vomiting

Indications for termination of pregnancy may include:

• incessant vomiting
• an increase in the level of acetone in urine tests,
• progressive loss of body weight,
• pronounced tachycardia,
• dysfunction of the nervous system,
• icteric staining of the sclera and skin,
• pronounced changes in acid-base status,
• hyperbilirubinemia.

However, most often this pathology occurs without pronounced manifestations and is successfully treated without leading to serious consequences in pregnant women.

Many women begin to feel their pregnancy from its first weeks. Some people notice a different reaction to smells, others complain about unusual taste preferences, and still others complain about very frequent mood changes. But all these signs fade at 4-5 weeks of gestation, when early toxicosis develops.

The most common manifestation of toxicosis during pregnancy is vomiting. It can be of varying degrees of severity: from slight nausea in the morning to repeated release of gastric contents, which can lead to dehydration. In addition, vomiting during pregnancy can not only manifest itself as toxicosis: during this period, other, more dangerous diseases develop that are manifested by this symptom.

Mechanism of development of vomiting

In the brain there is a so-called vomiting center: a collection of numerous nerve nuclei that receive impulses from the cardiovascular system, stomach, esophagus and intestines, as well as the limbic system - structures responsible for memory, emotions, sleep and wakefulness. The vomiting center is washed by cerebrospinal fluid, into which chemicals from the blood penetrate, so vomiting (emetic syndrome) often accompanies various poisonings. It is affected by intracranial pressure, so an increase or decrease in the latter also causes vomiting.

Emetic syndrome is a protective reflex. It is necessary to cleanse the stomach of toxic contents that have entered it and avoid intoxication of the body. Also, the syndrome is a signal for a person to find and eliminate the existing problem.

During pregnancy, emetic syndrome occurs due to the following reasons:

• diseases of the stomach and intestines;
• pathologies of the liver, pancreas and bile bladder;
• excessive stress;
• adrenal insufficiency;
• food or chemical poisoning;
• intracranial hypertension or, less commonly, hypotension;
• heart diseases (including myocardial infarction, for example, its painless form);
• diseases of the vestibular apparatus;
• diseases accompanied by intoxication: tonsillitis, sinusitis, pneumonia.

But in the early stages of pregnancy, vomiting can be an almost “normal” phenomenon that occurs in response to an increase in human chorionic gonadotropin hormone in the blood. And the more of this hormone (for example, with), the more pronounced the emetic syndrome is.

Vomiting of pregnancy (hyperemesis gravidarum)

This is the name of a condition that begins at 4-5 weeks of gestation, becomes as strong as possible by 9 weeks and completely stops by 16-18 (in rare cases - 22) weeks. It reminds itself every day during this period; usually accompanied by morning nausea and increased salivation. Intensifies with certain smells or visual images, as well as with memories of smells or things seen. Not accompanied by any abdominal pain or increased bowel movements.

Please note: the presence of a positive home test and emetic syndrome does not yet give reason to calm down and not go to the gynecologist. The same symptoms manifest themselves as hydatidiform moles (when instead of the fetus, its membranes develop, taking the form of bubbles). Moreover, vomiting during a hydatidiform mole will occur much more often, even without any external irritants.

If hyperemesis gravidarum occurs on an empty stomach or is repeated very often, bile may be present in the vomit. In other cases, this requires clarification of the diagnosis, since more dangerous diseases may manifest themselves in this way, for example, cholecystitis, duodenal diseases, and intestinal obstruction.

Scarlet blood in the vomit or its coloring brown (if the pregnant woman did not consume chocolate, Hematogen, or blood sausage) is clearly a symptom of the disease that requires prompt diagnosis.

Hyperemesis gravidarum is a “conditional” norm and does not require additional diagnostics during the first pregnancy and moderate manifestations. In cases where the syndrome is severe or repeats from pregnancy to pregnancy, it speaks of:

• the presence of diseases of the reproductive organs: recurrent course (these diseases do not always have pronounced manifestations);
• chronic pathology of the digestive system, be it gastritis, cholecystitis, hepatitis or biliary dyskinesia;
• poor nutrition or previous illness before pregnancy;
• anemia or allergic diseases.

What is the danger?

Chorionic gonadotropic hormone, together with the cerebrospinal fluid, enters the vomiting center. There it causes stimulation of a large number of nerve fibers at once, and this is accompanied by nausea and vomiting. Excitation of the nerves is usually transmitted to areas of the autonomic nervous system, so the woman often also notices increased salivation.

Liquid is lost through vomit, which leads to dehydration and electrolyte imbalance in the body. Electrolytes are chlorine (the most of it is lost), magnesium, sodium, potassium, which are necessary for the normal functioning of the woman and the fetus. These ions carry a negative or positive charge, and when their balance in the blood is maintained, alkaline and acidic substances are in balance and all organs function correctly. When electrolytes begin to be excreted unevenly, the pH of the blood changes - the whole body suffers.

With emetic gestational syndrome, large amounts of chlorine are lost. Chlorine is a negatively charged ion involved in the formation of acidic substances. When it is lost, the blood becomes alkaline in pH. This causes headaches and disruption of the heart. Loss of large amounts of chlorine through gastric juice can lead to impaired consciousness and convulsions. These are not the same convulsions that are life-threatening in the second half of pregnancy and are called “eclampsia.”

Due to constant vomiting, a woman stops eating or reduces the amount of food consumed. To satisfy the need for energy, the body first uses glycogen, then energy begins to be extracted from fats accumulated by the body. During the breakdown of fats, ketone (acetone) bodies are formed, which have a toxic effect on the brain, causing drowsiness, further increasing vomiting. In the severe stage, which is called uncontrollable vomiting of pregnant women, the liver, kidneys, and heart suffer, and this is reflected in the tests.

Severity of the condition

Since this syndrome, especially in combination with increased salivation, causes an imbalance of water and electrolyte balance, the classification of vomiting during pregnancy is used to determine treatment tactics. It includes three degrees of severity.

1st degree

Develops no more often than 5 times a day. The woman is active, not drowsy, and goes about her daily activities. Her pulse is no more than 80 per minute (or no higher than the original pre-pregnancy values), and her blood pressure is not reduced. She may lose 2-3 kg. In a urine test, acetone bodies are not detected, biochemical blood parameters are normal.

2nd degree

Vomiting 6-10 times a day. An always active woman feels weak and drowsy. Her pulse is increased to 90-100 per minute (if the initial one was in the range of up to 80). 1-2 pluses of acetone are detected in urine. Blood tests are still normal. Weight loss is more than 3 kg/7-10 days.

3rd degree

It is also called excessive (uncontrollable) vomiting. It develops up to 25 times a day, which is why a woman cannot eat at all. Due to the presence of acetone in the blood (it is determined in the urine as 3-4 plus), the woman cannot eat or drink, loses 8 kg or more, and produces little urine. Acetone syndrome also causes an increase in temperature to 37.2-37.6 and an increase in heart rate to 120 per minute and above. When significant dehydration occurs, the temperature and blood pressure drop, the woman becomes extremely drowsy and her mind becomes confused.

A urine test detects acetone, protein and casts, which indicates kidney damage. There is increased bilirubin in the blood (indicating liver damage) and creatinine (further confirming kidney damage). If bilirubin is significantly increased (the norm is 20 µmol/l), yellowing of the whites of the eyes and skin becomes noticeable. Due to liver damage, bleeding increases and blood discharge from the vagina may occur. Often, streaks of blood are found in the vomit, and in this case it is necessary to exclude ruptures of the esophagus that occurred as a result of such repeated vomiting.

All the manifestations described above relate to vomiting during pregnancy. If nausea is accompanied by abdominal pain, diarrhea, fever, headache, you should consult a doctor.

Other causes of vomiting during pregnancy

Let's look at diseases that can cause vomiting in a pregnant woman. To more accurately determine the possible cause of your condition, we will group diseases according to symptoms that complement the emetic syndrome.

So, vomiting bile during pregnancy can occur with:

• intestinal obstruction, which is accompanied by abdominal pain, bloating, constipation;
• exacerbation of chronic cholecystitis (in this case, there is pain in the right hypochondrium, increased temperature);
• biliary dyskinesia (it is also characterized by pain in the right hypochondrium, vomiting occurs more often in the morning);
• tumors mainly localized in the duodenum;
• exacerbation of chronic pancreatitis (this is characterized by pain in the upper abdomen, loose stools).

If there is a combination of dizziness and vomiting, this often indicates:

1. Pathologies of the vestibular apparatus (Meniere's disease, inflammation of the inner ear). Additional symptoms include hearing loss, nystagmus (twitching of the eyeballs), and ringing in the ears. Only with inflammation of the structures of the inner ear are an increase in body temperature and, sometimes, discharge from the ear; Meniere's disease does not have such symptoms.
2. when fetal tissue decay substances are absorbed into the blood. When combined with a cough and fever, symptoms may indicate the development of pneumonia. And if the vomiting is constant (grade 3), dizziness is due to dehydration.

When vomiting with blood is observed, this may indicate gastritis or gastroenteritis, ulcers and stomach cancer, Mallory-Weiss syndrome. If the vomit contains dark red blood, this may be a sign of bleeding from gastric or esophageal varices, which develops due to cirrhosis of the liver.

When vomiting and diarrhea are combined, they speak of food poisoning, intestinal infection (salmonellosis, escherichiosis and others), pancreatitis, thyrotoxicosis. Sometimes this is how atypical forms of pneumonia manifest themselves.

Vomiting in the second and third trimester of pregnancy

The second trimester is weeks 13-26. Vomiting before the 22nd week of gestation can be observed as a reaction to the fetus (although from 18 to 22 weeks other causes of the symptom must be further excluded).

From 22 weeks, the causes may be the diseases described above, as well as conditions characteristic only of pregnancy:

1. Late gestosis, which is manifested by edema (sometimes this is noticeable only by weight gain), increased blood pressure, the appearance of protein in the urine, and sometimes diarrhea. If gestosis is accompanied by emetic syndrome, this indicates a worsening of its course with the possible development of eclampsia. The recommendations here are only inpatient treatment with possible early delivery.
2. Intrauterine death of the fetus, which is manifested by the cessation of its movements, heaviness in the lower abdomen, and increased heart rate.

Unlike, which “spreads” over 2 trimesters at once and is considered a variant of the woman’s body’s individual reaction to the fertilized egg, vomiting in the third trimester is definitely a sign of the disease. The condition requires mandatory hospitalization and clarification of the causes that cause it.

The main causes of vomiting from the 26th week until the end of pregnancy are poisoning, pneumonia, diseases of the gastrointestinal tract and nervous system, surgical diseases of the abdomen, as well as fetal death. Separate mention should be made of Sheehan syndrome or acute fatty liver degeneration. It begins at 30 weeks and mainly affects primigravidas. Manifested by lack of appetite, nausea and vomiting, the appearance of jaundice, edema, tachycardia.

Considering the variety of etiological factors, a doctor should say what to do when vomiting in pregnant women is based on the examination results.

Therapy

Treatment of vomiting of pregnancy, which develops in the 1st trimester, depends on the severity of the condition.

Thus, stage 1 usually does not require drug treatment; it goes away under the influence of routine measures: frequent and small meals, exclusion of fatty and high-calorie foods. In rare cases, hyperemesis gravidarum progresses to the next stage.

In the first degree, mainly folk remedies are used:

• drink a glass of not very cold water on an empty stomach;
• drinking a decoction of lemon balm and rosehip throughout the day;
• drinking tea with a piece of ginger root grated into it;
• chewing cumin seeds;
• alkaline water (Borjomi), from which gas has been released;
• eating various nuts, dried fruits, small pieces of citrus fruits. You should start your first morning meal with nuts;
• rinsing the mouth with chamomile decoction;
• eating foods rich in pyridoxine: avocados, eggs, chicken, beans, fish.

If vomiting during pregnancy is of grade 2 severity, medications are used for treatment. These are antiemetics (Osetron, Metoclopramide), folic acid, vitamin pyridoxine, sorbents (Polysorb, White Coal), drugs that improve liver function (Hofitol). Meals are very frequent and in small portions.

For grade 3, hospitalization is required. Oral nutrition is completely excluded: all nutrients are injected into a vein until the acetonemic state is relieved. Antiemetics are also injected into a vein, and vitamin B6 is administered intramuscularly.

We remind you once again: emetic syndrome that occurs after 22 weeks, and especially in the third trimester, is an indication for immediate hospitalization. Self-medication is unacceptable here.

For many, even experienced mothers, the state of pregnancy is strongly associated with such concepts as vomiting and nausea. Why does this happen and why is it not always the norm? We will cover these issues in detail in our article.

Vomiting during pregnancy: causes

First, let's list the reasons directly related to pregnancy. In such cases, vomiting may be a variant of this “wrong norm.”

Early toxicosis of pregnant women. The classic forms of this condition are: vomiting of pregnancy, drooling and dermatosis or pruritus of pregnancy. Nausea, lack or perversion of appetite and vomiting during pregnancy in the morning are the most common symptoms of toxicosis. According to general statistics, approximately half of expectant mothers experienced these conditions during the first 16 weeks of pregnancy. The reason for such unpleasant conditions lies in the formation of a special “pregnancy center” in the brain, which is responsible for vascular reactions, nerve impulses and emotional state. The “hormonal boom” in the body, especially high levels of progesterone, also negatively affects the motility of the gastrointestinal tract.

Toxicosis in pregnant women has varying degrees of severity:

• Mild degree. Nausea occurs sporadically, vomiting occurs once or twice a day in the morning. Her appetite is preserved, the pregnant woman is gaining weight, her general condition is impaired, and her performance is preserved. This condition does not require treatment and is corrected with nutrition.
• Average degree. A pregnant woman feels sick constantly throughout the day. Vomiting occurs several times a day. The pregnant woman does not gain weight or loses it slightly, but her general condition is not affected. This degree of toxicosis can be corrected with nutrition and light herbal preparations such as chamomile decoction or artichoke extract. Sometimes additional intravenous glucose infusions and antiemetics such as metoclopramide are required.
• Severe toxicosis, fortunately, is quite rare. This is a very serious condition. A pregnant woman feels sick not only in the morning or during the day, but even at night. Vomiting is indomitable. The woman rapidly loses weight, changes appear in blood and urine tests, kidney function deteriorates, and dehydration appears. The condition requires treatment in a hospital with the obligatory prescription of antiemetic drugs, droppers with nutrients and vitamins.

Fortunately, most often there is a mild degree of toxicosis, which goes away on its own by 12-16 weeks of pregnancy.

Vomiting of pregnancy in late stages. This situation is caused not so much by neuropsychogenic causes or the action of progesterone, but by the direct pressure of the uterus with the child on the walls of the stomach. After a hearty lunch, against the background of active kicking of the baby or bending of the body, pregnant women often experience an attack of vomiting. Vomiting in a pregnant woman after eating is usually an isolated situation and does not require treatment. However, you should not overeat or exercise excessively after eating.

When is vomiting in a pregnant woman a sign of illness?

However, vomiting should not always be attributed to the state of pregnancy: “This is toxicosis, it will go away on its own!” Let's look at examples when you need to distract yourself from the topic of toxicosis and correctly assess the situation. When is vomiting a reason to urgently consult a doctor?

1. Infectious vomiting. Such vomiting is usually accompanied by fever, diarrhea, abdominal pain, and general weakness. Sometimes a woman remembers that the day before she “ate something wrong” or from questioning it turns out that other family members have similar symptoms. Vomiting and diarrhea during pregnancy is a reason to urgently consult a therapist or infectious disease specialist to diagnose the type of intestinal infection and appropriate treatment. Read more about.
2. Vomiting due to high blood pressure or late gestosis. This type of vomiting occurs at the peak of increased blood pressure. This condition is very dangerous for both the expectant mother and the child, and requires urgent measures.
3. Vomiting after injury. Based on this criterion, neurosurgeons and traumatologists assess the severity of traumatic brain injury. If a woman hits her head, falls, or has an accident, vomiting is an unfavorable sign.
4. Vomiting bile during pregnancy is a sign of gastrointestinal dysfunction that is in no way related to pregnancy. Vomiting of green bile with a bitter taste occurs against the background of diseases of the liver, gallbladder and duodenum. This condition can also occur with prolonged uncontrollable vomiting, for example, with severe toxicosis.
5. Vomiting blood during pregnancy is also an extremely dangerous condition. Vomit may contain fresh blood, which is a sign of bleeding from the esophagus or oropharynx. Also, vomit may resemble brown or brown coffee grounds - this is the most striking symptom of a bleeding stomach ulcer. All these conditions require immediate hospitalization in the surgical department.

First aid for pregnant women with vomiting

First aid for a pregnant woman should be provided solely based on the causes of vomiting. It is better if this is done by a medical professional, having first correctly assessed the situation. In case of a normal attack of vomiting due to toxicosis, it is necessary to sit or lay down the pregnant woman to prevent her from losing consciousness, and offer strong sweet tea or plain clean water. If the blood pressure is high, it is necessary to give the woman certain medications and urgently send her to the hospital. When vomiting after a head injury, the patient should be treated by neurosurgeons. The list can be continued based on the previous paragraph of our article.

1. Frequent small meals. Food must be taken warm, but not hot, preferably in a lying or semi-lying position. Meals should be taken every two to three hours in small portions. For the first meal, it is important to choose foods that help relieve nausea and do not cause vomiting. There are no uniform recommendations on this matter. Some people benefit from viscous porridge, others from juicy fruits, others from black bread or sweet tea with crackers.
2. Compensation for fluid and potassium losses. It is important to replenish the loss of water and important ions by any means. You need to drink as much as possible. In addition, you need to include potassium-rich foods in your diet. These include bananas, persimmons, figs, dried apricots, raisins, and potatoes. An ideal drink to replenish fluid loss is dried fruit compote.

Is it dangerous to induce vomiting during pregnancy?

Sometimes women ask whether it is possible to induce vomiting in case of prolonged and non-productive nausea. Unfortunately, as a rule, such provoked vomiting does not bring relief. Moreover, inducing vomiting artificially is dangerous - it can lead to bleeding from the stomach or esophagus, increased blood pressure and fainting.

Alexandra Pechkovskaya, obstetrician-gynecologist, especially for the site