Patient's question:
My wife just got pregnant and is feeling particularly uncomfortable now. She has headaches and nausea. Is this normal? / She hasn't even been pregnant for a month yet and can't go to work.Doctor's answer:
It is appropriate to supplement with vitamin supplements. In addition, methods for dealing with pregnancy-related symptoms are as follows:1. Generally, during the early stages of pregnancy, women may experience mild food cravings, loss of appetite, aversion to food, mild nausea, vomiting, dizziness, and fatigue. These symptoms are more pronounced in the morning. This is a normal physiological response and is a unique symptom of pregnancy, known as pregnancy-related symptoms. Pregnancy-related symptoms typically appear around 5–6 weeks of gestation and gradually become more noticeable, usually resolving on their own before the 12th week of pregnancy. These symptoms generally do not significantly impact daily life or work and do not require special treatment.
Another condition is severe morning sickness, which is more common in first-time mothers. Initially, it may resemble typical early pregnancy symptoms but worsens progressively. It is usually most severe around the 8th week of pregnancy, characterized by frequent vomiting. In addition to nausea and vomiting upon waking, the mother may vomit even upon smelling cooking or seeing certain foods, leading to vomiting regardless of what is consumed—even water. The vomit may contain bile or coffee-ground-like material. Due to severe vomiting and prolonged hunger, the body consumes its own fat, causing ketone bodies (the intermediate metabolites of fat) to accumulate. This can lead to dehydration, electrolyte imbalances, acidosis, and positive ketone bodies in the urine. The pregnant woman may develop dry, wrinkled skin, sunken eyes, and significant weight loss, severely affecting her health and even posing a risk to her life. Clinically, this severe pregnancy-related symptom is referred to as severe morning sickness.
There are various theories regarding the causes or contributing factors of pregnancy-related symptoms. Some believe that these symptoms are related to the effects of human chorionic gonadotropin (hCG), as evidence shows that the onset of pregnancy-related symptoms aligns with the appearance and disappearance of hCG in the mother's blood. Others suggest that dysfunction of the autonomic nervous system may be involved. Some even propose that pregnancy-related symptoms are caused by toxins produced by the placenta, psychological factors, or other causes. Generally, individuals with a nervous disposition tend to experience more severe symptoms, and those with marital conflicts or who are reluctant to be pregnant may also experience more intense symptoms.
If a pregnant woman has severe pregnancy-related symptoms or feels uneasy, she should first consult a doctor. Additionally, the woman can take measures to alleviate the symptoms. The following suggestions may be helpful for pregnant women:
- Attend a prenatal education class to learn some medical knowledge about pregnancy. Understanding that life (carrying a child) is a sacred and (great) endeavor—one that involves both hardship and joy—can increase one's tolerance for the symptoms.
- Relax mentally and physically. Pregnancy-related symptoms are a normal physiological response, and most women recover within one or two months. Therefore, it is important to maintain a positive outlook and rest when feeling unwell.
- Shift focus to positive emotions. During free time, engage in activities one enjoys, such as organizing cherished belongings or reminiscing about happy memories. Thinking about the joy of (becoming a mother soon) can bring happiness. Socializing with friends, going on outings, or even doing some light makeup can also help. In short, do anything that makes one feel good and happy.
- Eat what one can. During this period, it is unnecessary to worry about nutritional balance or whether the fetus is receiving adequate nutrition. At this stage, the fetus is still very small and requires minimal nutrients.
- Seek support from husband and family. Due to the (specificity) of pregnancy-related symptoms, pregnant women may be reluctant to do household chores, especially if they are sensitive to cooking odors. Family members and the husband should understand what pregnancy-related symptoms are and actively share household responsibilities to help the woman cope more easily.
- Seek medical attention promptly. If urine tests show positive ketones, hospitalization is necessary. All hospitalized patients should undergo differential diagnosis, typically including an ultrasound to confirm fetal health and liver function tests, as well as hepatitis B serology to rule out conditions like gestational hepatitis B. The goal of hospitalization is "ketone elimination," achieved through intravenous fluids to convert positive ketones in the urine to negative. Initially, the patient may need to fast for 2–3 days, with nutrition and electrolyte balance being corrected primarily through intravenous fluids. After this treatment, symptoms usually improve rapidly, with vomiting stopping, increased urine output, and ketones turning negative in the urine. The patient can then gradually reintroduce small amounts of liquid food and increase intake or switch to softer foods.
If symptoms do not improve after treatment, especially if the mother's temperature remains above 38°C, heart rate exceeds 120 beats per minute, or jaundice occurs, the pregnancy should be considered for termination.