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The Motherisk Nausea and Vomiting of Pregnancy (NVP) Forum

Motherisk receives questions from around the world about morning sickness symptoms, effects, treatments and ways to cope. Those questions and answers are posted here for anyone to read, provided the reader acknowledges and accepts the proviso and disclaimer below.

Forum > NVP Symptoms and Effects: Planning ahead
What to expect during the second pregnancy

NVP Symptoms and Effects
Date: 2000-12-06

Question:
I am in the 7th week LMP of my second pregnancy. My first pregnancy was marked by hyperemesis gravidarum, which began as routine morning sickness in about my 7th or 8th week, culminating in hospitilization for intractable vomiting, severe dehydration, and weight loss at 14 weeks. From 14 weeks to delivery at 39 weeks, I was on a daily dose of phenegran. My question is this. In this second pregnancy I am beginning to exhibit signs of morning sickness. I am, obviously, being more proactive in home remedies - ginger ales and teas,bananas/applesauce/rice/toast diet, small meals, limited red meat and fat intake, etc. - but am wondering at what point I might be concerned of it occurring again? What is the likelihood and severity associated with a second pregnancy?

During my first pregnancy I was completely unaware of the condition, didn't know what was happening to me, and was constantly brushed off by my nurses when I reported early symptoms of vomiting and continued weightloss ("that's common at this stage in pregnancy," etc.), so you can see why I am unsure at what point the nausea got beyond my control the first time around. Any insight would be appreciated.

Answer:
No two pregnancies are alike and so you cannot expect to be affected to the same degree the second time. However, you are wise to be prepared and take steps to deal with NVP if and when it occurs. Here in Canada women are advised at the onset of NVP symptoms to start taking Diclectin, the approved medication for this condition. Most women take 4 pills a day - each pill contains 10 mg of Vitamin B6 and 10 mg of doxylammine succinate.

In countries where Diclectin is not available, doxylamine succinate can be taken at 40 mg daily and Vitamin B6 at 75 mg daily. Both these substances are known not to increase the baseline risk of 1% to 3% that is present in all pregnancies. Whatever treatment you and your doctor decide on, it should be started at the first onset of NVP for best results.

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