Causes of Nausea Late in Pregnancy

For most women, the first trimester of pregnancy is the time they are most likely to suffer from the nausea and vomiting of pregnancy (NVP)-more commonly referred to as morning sickness. Once the production of hCG has peaked, the hormonal fluctuations that are believed to be one of the primary causes of NVP start to level off. In some cases, the change occurs quite suddenly-one morning after being sick for weeks, you may get up and feel just fine. This signals the beginning of the best part of pregnancy for many-the second trimester.

By the last stage of pregnancy, however-the third trimester-some different kinds of discomfort are developing as the baby grows larger and simply takes up more space. One of these discomforts can be the return of nausea late in pregnancy and vomiting. This kind of nausea and vomiting that recur or start for the first time during the last phase of pregnancy may still be traced to the influence of the hormonal rollercoaster. But a number of other factors may also be coming into play at this time.

As the growing fetus takes up more room in the expectant mother’s abdominal cavity, nausea following mealtimes can become much more common. The pressure of the uterus on the stomach and the continued slowing of digestive motility make it increasingly important to follow some of the advice first given for early morning sickness: eat smaller amounts. The stomach’s capacity is ever-more limited and the muscles that move food through the digestive tract are working much more slowly, so it is very easy to overload your delicate equilibrium. Heartburn is particularly prevalent at this point, too, and in addition to being uncomfortable itself, it can easily trigger episodes of nausea and vomiting.

In addition to continuing or returning to eating smaller meals more frequently all through the day, the other common remedies for early NVP may well provide all the relief necessary. It doesn’t hurt that the end is in sight by now, too. However, there are some instances where late pregnancy nausea and vomiting are signs of more serious developments that could require medical attention.

First and foremost, if nausea and vomiting are constant and severe enough that the mother is unable to keep down enough food and liquids to maintain nutrition and hydration, the causes of the problem need to be investigated. The doctor will want to rule out some familiar non-pregnancy-related illnesses that cause nausea and vomiting and also check for a couple of rare but dangerous complications that can arise during the home stretch of pregnancy.

About 2 to 3 percent of pregnant women develop a severe form of NVP that is known as hyperemesis gravidarum. In milder cases this can be treated through some combination of the standard morning sickness remedies, but if those do not provide relief, prescription medications, hospitalization, bed rest, and alternative feeding approaches may be necessary.

Much rarer but also much more serious are HELLP syndrome, which is associated with preeclampsia, and acute fatty liver of pregnancy (ACLP). Both of these tend to present in the third trimester and can be fatal to both mother and child. Like hyperemesis gravidarum, severe and persistent nausea and vomiting are primary symptoms, but HELLP and ACLP may also bring pain in the stomach and upper-right abdomen, headaches, jaundice, excess thirst and urination, and/or a general feeling of malaise.

So while nausea and vomiting that continue, recur, or develop for the first time in the last three months of pregnancy are not automatically cause for alarm, if there is any concern that they are causing dehydration, lack of adequate nutrition, weight loss, or abdominal pain, the doctor should certainly be consulted for advice and if necessary a few simple tests to make sure that everything remains on track for a healthy delivery.



Source by Lisa C Packer



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