Timing of Nausea and Vomiting After Pregnancy Begins
Nausea and vomiting typically begins at 4-6 weeks of gestation, peaks at 8-12 weeks, and subsides by week 20 in most women. 1
Onset and Duration
Initial symptoms appear between 4-6 weeks of pregnancy (approximately 2-4 weeks after conception or around the time of the first missed period). 1
Peak severity occurs at 8-12 weeks of gestation, when symptoms are most intense for the majority of affected women. 1
Resolution typically happens by week 16-20 of pregnancy, though the exact timing varies. 2, 3
Approximately 70-80% of all pregnant women experience some degree of nausea and vomiting during pregnancy. 4, 5
Important Clinical Context
In a subset of women, symptoms persist throughout the entire pregnancy, affecting quality of life significantly. 2
Hyperemesis gravidarum (the severe form) affects 0.3-10.8% of pregnancies and represents progression from typical nausea and vomiting when left untreated. 4
Early intervention is crucial as it may prevent progression to hyperemesis gravidarum, which can lead to significant maternal morbidity including dehydration, electrolyte imbalances, weight loss >5%, and in severe cases, Wernicke's encephalopathy. 1, 6
Common Pitfall
The most common mistake is dismissing early pregnancy nausea and vomiting as "normal" without assessing severity. Use the PUQE score to objectively categorize symptoms as mild (≤6), moderate (7-12), or severe (≥13) to guide appropriate treatment intensity from the outset. 1