Abstract
Globally, 50% - 90% of pregnant women are affected by morning sickness of pregnancy, especially during the first trimester. Therefore this study was carried out to establish if there is association between urinary hCG levels and severity of nausea, retching and vomiting among pregnant women attending antenatal care (ANC) services at Ishaka Adventist Hospital (IAH). It was a quantitative cross-sectional study in which a pre-tested and standardized questionnaire with a mixture of both open and closed ended questions was used to collect data from respondents to determine the clinical history, socio-demographic characteristics, and clinical features of morning sickness and/or hyperemesis gravidarum. Urine samples were also collected from each participant and analyzed using the Beckman Coulter Access 2 immunoassay system and Access Total hCG reagent pack at Mbarara University of Science and Technology. The findings showed that 63% of the respondents experienced morning sickness with the majority having a mild form. There was also no significant relationship between hCG levels and severity of morning sickness and no correlation between physiological characteristics (gravidity, age and weight) (correlation coefficient -0.05186, -0.0469 and 0.157 respectively). In addition, there was no correlation between cravings, aversions and morning sickness (correlation coefficient -0.0262 and 0.227 respectively). In conclusion, the study revealed that there was a high prevalence of morning sickness of pregnancy although, it was mild; no association between severity of morning sickness and levels of hCG as well as correlation between cravings and aversions with hCG levels in the study population. Considering the limitations of this study, it is recommended that studies should be undertaken for the quantitative determination of total hCG levels in urine for all pregnant women with morning sickness to be able to draw a definitive conclusion.
Highlights
There are many theories about what causes morning sickness most of which are not proven, the most widely-held view is that it is probably a combination of factors that may include, among other theories, unstable blood sugars, hormone activity, changes in blood composition and the sex of the baby
Study Population Pregnant women who were in the first trimester and who were receiving antenatal care (ANC) services from Ishaka Adventist Hospital during the period of study
From the findings of the study, majority (63%) of the respondents experienced morning sickness. This is in line with Gadsby et al [19], who reported that the prevalence of nausea, retching and vomiting in early pregnancy ranges from 50% - 85% in Western population
Summary
There are many theories about what causes morning sickness most of which are not proven, the most widely-held view is that it is probably a combination of factors that may include, among other theories, unstable blood sugars, hormone activity, changes in blood composition and the sex of the baby. Whereas large numbers of women (50% - 90%) are affected with morning sickness globally, the levels of hCG responsible for the severity of nausea, retching and vomiting are not known for certain, leave alone the fact that there might be variations in different populations. The essence of study was informed on the facts that there exists limited information on the factors that may be influencing the severity of hyperemesis gravidarum/morning sickness at various levels of hCG, other than the hormone alone, requires investigation. Whereas large numbers of women (50% - 90%) are affected by morning sickness, globally, the levels of hCG responsible for the severity of nausea, retching and vomiting are not known. In Uganda, there are no reports on any study done to relate the severity of morning sickness and hCG levels in the urine of the affected women. The present study was carried out to evaluate the alteration of human chorionic gonadotropin levels among pregnant women with morning sickness attending antenatal care services services at Ishaka Aventist hospital, Uganda
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