Women's Health Center Blog
Written By Dr. Christopher Johnson
This month's issue of Obstetrics and Gynecology, or the Green Journal, the official publication of the American Congress of Obstetricians and Gynecologists, contained a new technical bulletin regarding nausea and vomiting in pregnancy. The publication was written by Dr. Susan Rame, a very highly regarded researcher and teacher, who did her fellowship at Parkland Hospital in Dallas, TX, where most of my teachers also trained.
Since up to 80% of all pregnant women suffer some degree of nausea and vomiting in pregnancy (often termed morning sickness), this is a very common problem we encounter frequently. The more sever cases are given the term "nausea and vomiting increases so as to seriously affect the women's quality of life. The most rare but most sever are even possible life-threatening form is termed "hyperemesis gravidarum". In these, thankfully, rare cases, the condition leads to near nonstop vomiting with associated dehydration, weight loss, and need for hospitalization.
There is a very carefully constructed formula for treatment contained in the publication. The treatments begin without medication, including the use of ginger, stopping the prenatal vitamin, and using over-the-counter available wristband on the acupressure point just above the wrist. The algorithm continues with the safest and best medications all the well-studied and commonly used in our practice. What was new and very important was the Dr. Ramen stressed that early treatment in the milder stages can prevent the progression to more sever forms with their associated risks. This is a major change in that previously we would save treatment for the more sever cases. This emphasis on earlier treatment places more importance on early prenatal care and the shared decision-making we have with our patients.
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