Some Causes and Features of Nausea and Vomiting During Early Pregnancy
Cause | Common Features | Diagnostic Approach† |
|---|---|---|
Related to the pregnancy (obstetric) | ||
Nausea and vomiting of pregnancy (morning sickness) | Mild nausea and vomiting that comes and goes and that occurs at varying times throughout the day, primarily during the 1st trimester | A doctor’s examination |
Frequent, persistent nausea and vomiting Inability to consume enough fluids, food, or both Usually signs of dehydration, such as decreased urination, decreased sweating, a dry mouth, increased thirst, a rapid heart rate, and dizziness when standing up Weight loss | Blood tests to check for signs of dehydration and chemical imbalances by measuring levels of electrolytes, blood urea nitrogen (BUN), creatinine, and liver enzymes Urine tests to measure ketones (produced when not enough food is consumed and the body breaks down fats for energy) | |
A molar pregnancy (abnormal placental growth with or without a fetus due to an abnormally fertilized egg) | A uterus that is larger than expected for the weeks of pregnancy No heartbeat or movement detected in the fetus Later in pregnancy, sometimes high blood pressure, swelling of the feet or hands, vaginal bleeding, or passage of tissue that resembles a bunch of grapes | Blood tests to measure human chorionic gonadotropin (hCG―a hormone produced by the placenta early in pregnancy) Ultrasonography of the pelvis |
Not related to the pregnancy | ||
A urinary tract infection or kidney infection (pyelonephritis) | An urge to urinate often (frequency), pain with urination (dysuria), or a compelling need to urinate immediately (urgency) With kidney infection, pain in the side or back and fever | Urine tests (urinalysis) and culture |
Vomiting that began suddenly, usually accompanied by diarrhea Sometimes recent contact with infected people or animals or recent consumption of undercooked, contaminated food or contaminated water | A doctor’s examination Sometimes, a stool sample | |
A blockage in the intestine (intestinal obstruction) | Nausea and vomiting that begins suddenly, usually in women who have had abdominal surgery in the past or who have abdominal cancer or an inguinal hernia Crampy pain and a swollen abdomen | X-rays Sometimes ultrasonography of the abdomen Sometimes CT (if x-ray and ultrasound results are unclear) |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† In pregnant women with concerning symptoms, the doctor assesses maternal vital signs, does a physical examination, and evaluates the status of the fetus with a fetal heart rate monitor or ultrasound. | ||
CT = computed tomography. | ||