Cessation of NVP from first day of last period (LMP)
5. CESSATION OF NVP FROM FIRST DAY OF LAST PERIOD (LMP)
27% of women’s symptoms had ceased by the end of the 10th week
From LMP. (50) 363 women
27% of women’s symptoms had ceased by the 12th week. (27) 500 women
60% of women’s symptoms had ceased by the end of the 12th week. (50)
70% of women’s symptoms had ceased by the 13th week. (23) 78 women
80% of women’s symptoms had ceased by the end of the 14th week. (50)
50% of women’s symptoms resolved by the 14th week. (80) 160 women
91% of women’s symptoms had ceased by the end of the 16th week. (50)
95% of women’s symptoms had ceased by four months. (19) 104 women
87% of women’s symptoms had ceased by the end of the 20th week. (40) 1,000 women
75% of women’s symptoms had ceased by the 20th week. (21) 414 women
90% of women’s symptoms resolved by the 22nd week. (80) 160 women
81% of women’s symptoms had ceased by the 26th week. (15) 86 women
Mean day NVP ceased 16.9 ± 3.1 weeks of gestation. (91) 260 women
Pooled population in 9 studies 3125 women
Mean week for cessation of NVP end of week 12 (50); by the 14th week (80) or by the 13th week. (23) Pooled population 738
These results for cessation of NVP are variable. Range from 9 studies: 91% of women’s symptoms ceased by the end of the 16th week from LMP. 90% of women’s symptoms resolved by the 22nd week.
OTHER FACTORS CONCERNING CESSATION OF NVP
1a. 29.3% of women’s NVP appeared to stop suddenly, that is they reported 14 or more hours of nausea in the week prior to cessation. (50)
1b. Most women find that morning sickness disappears at right about the three month mark. It’s a truly magical feeling the day you wake up and go to the kitchen eagerly thinking of breakfast. It happens just like that - one day you are miserable and the next you’ve never felt better.
Iovine Vicki. The Best Friends Guide to Pregnancy ‘Morning Sickness’ - pages 35-39.
2a. NVP did not disappear at 12 weeks but rather tapered off throughout the early second trimester or continued into the 5th month particularly if severe. 27 women in study. (103)
2b. Nausea persisted significantly longer among women whose nausea was accompanied by vomiting than among women with nausea alone. (21)
2c. The percentage of women experiencing vomiting decreased by 20% during the 17-20 week interval and only 9% of women complained of vomiting, unassociated with fever or diarrhoea, after 20 weeks. 8019 women in study, 4517 women vomited. (18)
3. Cessation of NVP occurred at approximately the same day from LMP whether the symptoms began early, before day 28 from LMP, or later, after day 49 from LMP, or severely or mildly, that is those women who had less than 36 hours of nausea in all seven day periods up to day 49 from LMP (mildly) or those women who experienced more than 36 hours of nausea in any seven day period up to day 49 from LMP (severely). (50)
4. A finding was that 23% of this study has uninterrupted daily nausea for an average of 44-46 days, while 20% who had one complete day of interruption of their nausea averaged 24.7 days with nausea (80). 160 women in study.
1. NVP will stop suddenly in about 30% of women but will taper off for the remaining 70%.
2. A complete day of no NVP symptoms is an encouraging sign that cessation will not be too long delayed.
3. Early symptoms of NVP are not an indication of how long NVP will last from LMP. Obviously, on average ladies whose symptoms start early, before day 28 from LMP will have more hours of nausea, than those whose symptoms start late after day 49 from LMP as in both situations NVP stops at about the same time from LMP 12-14 weeks mean day 84 (50).
Did you know?
Early access to treatments is likely to be more effective and may prevent symptoms developing into HG
Please note this guideline is for moderate to severe NVP symptoms rather than HG
RCOG Green-top Guideline No. 69
The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum
BMJ Clinical Update 2018
Management of severe pregnancy sickness and hyperemesis gravidarum
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