What Might Be the Risk Factors of Pregnancy Nausea & Diarrhea?

Most of the information available from doctors, books, and online medical resources takes pains to stress how normal it is for pregnant women to experience nausea and other complications of pregnancy, like constipation or pregnancy nausea diarrhea. Not only normal, but harmless, in something close to 99 out of 100 instances. This reassurance is valuable, because pregnancy, especially a first pregnancy, is a time when women are likely to feel particularly concerned and uncertain. The stakes are so high, after all--the health and safety of the baby.

But while nausea and vomiting of pregnancy (NVP) is indeed a normal aspect of pregnancy that affect anywhere from 50 percent to 85 percent of women, there is a huge range in the discomfort associated with NVP. According to one recent report, vomiting alone is relatively rare, while 25 percent of women experience only nausea, and 50 percent have both nausea and vomiting.

At its worst, pregnancy nausea goes beyond being "normal" and can become a serious condition that poses risks for the health of the expectant mother and even her child. Untreated, HG makes it impossible for a woman to keep any food or nutrition in her system and can cause significant weight loss (often more than 10%), dehydration, nutritional deficiencies, gastric ulcers, esophageal bleeding, ketosis, metabolic problems and an inability to function normally in daily activities.

Those risks go even higher if nausea and vomiting is compounded by another ailment like diarrhea, which also causes dehydration. In serious cases, treatment of dehydration can require hospitalization and intravenous fluid replacement.

The official name for morning sickness that is not normal is hyperemesis gravidarum (HG)--extreme nausea and vomiting of pregnancy. Estimates of the frequency of HG vary from less than one percent to three percent of pregnancies. Since HG is basically just a more severe version of a common illness, there is no perfectly clearcut test for determining when ordinary pregnancy nausea shades into the danger zone. This can make it difficult for a woman to know when her own experience of nausea and vomiting is serious enough that she should be concerned and seek further counseling and treatment from her Ob/Gyn or other pregnancy advisors. It's not even a simple diagnosis for physicians.

Researchers and practitioners at the Motherisk NVP helpline in Canada have developed an assessment guide to aid them in this diagnosis process. Called the Pregnancy-Unique Quantification of Emesis/Nausea (PUQE) Index, it relies on three questions to determine if a woman's morning sickness is severe. If the score indicates a severe condition, follow-up should include determining the extent of weight loss, specific symptoms of dehydration, and lab tests to determine if there are electrolyte imbalances.

In cases where nausea and vomiting begin after the 10th week of pregnancy, that may be a sign that it is being caused by something other than normal pregnancy nausea, and merits further investigation.

Of course the number one risk associated with severe NVP is the potential harm to the health of mother and child. In very extreme cases, women become so ill that they may be forced to abort a pregnancy. But other kinds of costs and risks are also involved. At least half of the women affected by morning sickness find that their ability to perform their jobs is hampered; a quarter of all women have to miss work entirely. Lost productivity, medications, doctors' visits and hospital care all add up to a huge financial burden for individuals, businesses and the healthcare system.