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JAMA Patient Page
October 4, 2016

Treatments for Nausea and Vomiting During Pregnancy

JAMA. 2016;316(13):1420. doi:10.1001/jama.2016.14737

Nausea and vomiting during pregnancy, also known as “morning sickness,” is a common and treatable problem.

Nausea and Vomiting During Pregnancy

No one knows exactly why nausea and vomiting occur during pregnancy, but the symptoms are very common and experienced by more than 85% of pregnant women. The term “morning sickness” is not entirely accurate, as most women have symptoms throughout the day. The symptoms can range from mild to severe, sometimes even requiring hospitalization due to weight loss and dehydration. Hyperemesis gravidarum, the most severe form of nausea and vomiting during pregnancy, affects up to 3% of pregnant women. Symptoms of nausea and vomiting are usually worse during early pregnancy. Most women feel better after the fourth or fifth month, but some can have symptoms through the entire pregnancy.

Approach to Treatment

Because there is no clear cause for nausea and vomiting during pregnancy, the focus of treatment is on reducing the severity of symptoms. The first approach is to prevent symptoms by changing the diet. For example, it may help to eat foods that are bland, dry, and high in carbohydrates or protein and to avoid foods with strong flavors or odors. It also helps to eat smaller, more frequent meals and to eat before feeling hungry, because an empty stomach can worsen symptoms. Sipping cold fluids and sucking on ice chips can also help. However, if dietary changes are not enough, a variety of over-the-counter and prescription treatments are available.

The October 4, 2016, issue of JAMA includes an article that discusses several of these treatment options that have been studied. Overall, the studies done on this topic have not been of the highest quality; therefore, it is hard to say how well each treatment works. The options discussed below have been shown to have at least some benefit, but more high-quality research is needed.

Treatment Options

Over-the-counter remedies that have been shown to be useful for mild nausea and vomiting during pregnancy include

  • Ginger

  • Vitamin B6 (pyridoxine)

  • Acupressure (using sea bands)

Prescription medications that have been shown to be useful for moderate nausea and vomiting during pregnancy include

  • Vitamin B6/doxylamine combination

  • Antihistamines (eg, hydroxyzine)

  • Dopamine antagonists (eg, metoclopramide or promethazine)

  • Serotonin antagonists (eg, ondansetron)

Corticosteroids have been used in hyperemesis gravidarum and other severe cases of nausea and vomiting, but their use has not been well studied, and their benefit is not well established.

Talk to your doctor before taking any over-the-counter or prescription medications while pregnant.

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FOR MORE INFORMATION

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at www.jama.com. Spanish translations are available in the supplemental content tab.

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Article Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Source: McParlin C, O’Donnell A, Robson SC, et al. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review. JAMA. doi:10.1001/jama.2016.14337

Topic: Obstetrics

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