[Vomiting in pregnancy. When is it more than only a bothersome nuisance?]

In industrial countries more than half of women complain of nausea and vomiting during the first trimenon. Morning sickness, the common term of gestational nausea and vomiting, is usually temporary and harmless, it persists in less than 20% of all pregnancies. Maternal and fetal prognosis of uncomplicated emesis gravidarum is good. The responsible hormone as the pathogenetical trigger has not been defined yet, genetical and psychosocial factors may influence the intensity and duration of disease. The uncomplicated emesis has to be distinguished from hyperemesis gravidarum, a disorder which occurs in 0.3-2% of all pregnancies and is potentially of life-threatening character. While the uncomplicated form generally does not need any special therapy, hyperemesis gravidarum requires immediate compensation of fluid- and electrolyte loss, adequate supplementation of calories and vitamins as well as antiemetic therapy. Prospective studies have demonstrated that antihistamines are safe and effective for treatment of nausea and vomiting of pregnancy, in addition, also metoclopramide posses a high efficacy and safety profile.