Editing Morning sickness (section)

{{short description|Nausea due to pregnancy}}
{{distinguish|Mourning sickness}}
{{Infobox medical condition (new) 
| name            = Morning sickness
| field           = [[Obstetrics]]
| synonyms        = Nausea and vomiting of pregnancy, nausea gravidarum, emesis gravidarum, pregnancy sickness
| symptoms        = [[Nausea]], [[vomiting]]<ref name=ACOG2015Full/>
| complications   = [[Wernicke encephalopathy]], [[esophageal rupture]]<ref name=ACOG2015Full/>
| onset           = 4th [[Gestational age (obstetrics)|week of pregnancy]]<ref name=Fes2009/>
| duration        = Until 16th week of pregnancy<ref name=Fes2009/>
| types           = 
| causes          = Unknown<ref name=Fes2009/>
| risks           = 
| diagnosis       = Based on symptoms after other causes have been ruled out<ref name=ACOG2015/>
| differential    = [[Hyperemesis gravidarum]]<ref name=ACOG2015Full/>
| prevention      = [[Prenatal vitamins]]<ref name=ACOG2015/>
| treatment       = [[Pyridoxine/doxylamine|Doxylamine and pyridoxine]]<ref name=ACOG2015/><ref name=Kor2014/>
| medication      = 
| prognosis       = 
| frequency       = ~75% of pregnancies<ref name=Kor2014/><ref name=Ei2013/>
| deaths          = 
}}
<!-- Definition and symptoms -->

'''Morning sickness''', also called '''nausea and vomiting of pregnancy''' ('''NVP'''), is a [[Symptoms and discomforts of pregnancy|symptom of pregnancy]] that involves [[nausea]] or [[vomiting]].<ref name=ACOG2015Full/> Despite the name, nausea or vomiting can occur at any time during the day.<ref name=Fes2009/> Typically the symptoms occur between the 4th and 16th [[Gestational age (obstetrics)|weeks of pregnancy]].<ref name=Fes2009/> About 10% of women still have symptoms after the 20th week of pregnancy.<ref name=Fes2009/> A severe form of the condition is known as [[hyperemesis gravidarum]] and results in weight loss.<ref name=ACOG2015Full>{{cite journal | vauthors =  | title = Practice Bulletin No. 153: Nausea and Vomiting of Pregnancy | journal = Obstetrics and Gynecology | volume = 126 | issue = 3 | pages = e12–e24 | date = September 2015 | pmid = 26287788 | doi = 10.1097/AOG.0000000000001048 | s2cid = 19552518 }}</ref><ref name=Women2010>{{cite web|title= Pregnancy|url= http://www.womenshealth.gov/pregnancy/you-are-pregnant/pregnancy-complications.html|website= Office on Women's Health|access-date= 5 December 2015|date= September 27, 2010|url-status= dead|archive-url= https://web.archive.org/web/20151210060201/http://womenshealth.gov/pregnancy/you-are-pregnant/pregnancy-complications.html|archive-date= 10 December 2015}}</ref>

<!-- Cause and diagnosis -->
The cause of morning sickness is unknown but may relate to changing levels of the hormone [[human chorionic gonadotropin]].<ref name=Fes2009>{{cite journal | vauthors = Festin M | title = Nausea and vomiting in early pregnancy | journal = BMJ Clinical Evidence | volume = 2009 | date = June 2009 | pmid = 21726485 | pmc = 2907767 }}</ref> Some have proposed that morning sickness may be useful from an [[evolutionary]] point of view.<ref name=ACOG2015Full/> Diagnosis should only occur after other possible causes have been ruled out.<ref name=ACOG2015/> [[Abdominal pain]], fever, or [[headache]]s are typically not present in morning sickness.<ref name=ACOG2015Full/>

<!-- Prognosis, history, epidemiology, and culture -->
Morning sickness affects about 70–80% of all pregnant women to some extent.<ref name=Kor2014/><ref name=Ei2013>{{cite journal | vauthors = Einarson TR, Piwko C, Koren G | title = Prevalence of nausea and vomiting of pregnancy in the USA: a meta analysis | journal = Journal of Population Therapeutics and Clinical Pharmacology | volume = 20 | issue = 2 | pages = e163–e170 | date = 2013-01-01 | pmid = 23863545 }}</ref> About 60% of women experience vomiting.<ref name=Fes2009/> Hyperemesis gravidarum occurs in about 1.6% of pregnancies.<ref name=ACOG2015Full/> Morning sickness can negatively affect [[quality of life]], result in decreased ability to work while pregnant, and result in health-care expenses.<ref name="ACOG2015">{{cite journal |vauthors= |date=September 2015 |title=Practice Bulletin Summary No. 153: Nausea and Vomiting of Pregnancy |url=https://journals.lww.com/greenjournal/citation/2015/09000/practice_bulletin_summary_no__153__nausea_and.42.aspx |journal=[[Obstetrics & Gynecology (journal)|Obstetrics and Gynecology]] |type=Review <!-- from pubmed --> |volume=126 |issue=3 |pages=687–688 |doi=10.1097/01.aog.0000471177.80067.19 |pmid=26287781 |s2cid=39256123 |url-access=subscription}}</ref> Generally, mild to moderate cases have no effect on the fetus, and most severe cases also have normal outcomes.<ref name=ACOG2015Full/> Some women choose to have an [[abortion]] due to the severity of symptoms.<ref name=ACOG2015Full/> Complications such as [[Wernicke encephalopathy]] or [[esophageal rupture]] may occur, but very rarely.<ref name=ACOG2015Full/>

<!-- Prevention and treatment -->
Taking [[prenatal vitamins]] before pregnancy may decrease the risk.<ref name=ACOG2015/> Specific treatment other than a bland diet may not be required for mild cases.<ref name=Fes2009/><ref name=Women2010/><ref name=ACOG2015/> If treatment is used the combination of [[Pyridoxine/doxylamine|doxylamine and pyridoxine]] is recommended initially.<ref name=ACOG2015/><ref name=Kor2014>{{cite journal | vauthors = Koren G | title = Treating morning sickness in the United States--changes in prescribing are needed | journal = American Journal of Obstetrics and Gynecology | volume = 211 | issue = 6 | pages = 602–606 | date = December 2014 | pmid = 25151184 | doi = 10.1016/j.ajog.2014.08.017 | doi-access = free }}</ref> There is limited evidence that [[ginger]] may be useful.<ref name=ACOG2015/><ref name="ReferenceB" /> For severe cases that have not improved with other measures [[methylprednisolone]] may be tried.<ref name=ACOG2015/> [[Tube feeding]] may be required in women who are losing weight.<ref name=ACOG2015/>