Excessive Saliva

INFORMATION FOR WOMEN WHO HAVE EXCESSIVE SALIVA DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is excessive saliva during pregnancy?

During pregnancy, some women have a tendency to form excessive amounts of saliva, a condition that is known by many medical terms including ptyalism gravidarum, hypersalivation, and sialorrhea of pregnancy. Occasionally, the condition also includes nausea and vomiting.

How common is excessive saliva during pregnancy?

It is common to experience increased amounts of salivation during the first trimester of pregnancy, but excessive salivation during pregnancy, characterized by production of 1-2 liters of extra saliva per day, is fairly rare and its incidence varies between countries. A study in Japan, for instance, reported that the condition affects about 3 per 1,000 pregnancies. However, an American study back in the 1950s reported a rate as high as 2.4 percent. It is possible that many women suffering from the condition do not report it.

How is excessive saliva during pregnancy diagnosed?

Ptyalism gravidarum is diagnosed clinically, based on a pregnant woman reporting excessive salivation measured at more than 1 liter per day. This can be achieved by spitting accumulating saliva into a container with volume measurements. Some specialists believe that the presence of nausea and vomiting together with excess salivation increases the case for a ptyalism gravidarum diagnosis, but the diagnosis can be made based on extreme salivation (more than 1 L per day) alone. Your doctor also may wish to run tests to rule out the presence of conditions of the salivary gland unrelated to pregnancy. Such tests may include imaging and a biopsy (taking a sample of the gland through a needle and testing the sample).

Does excessive saliva cause problems during pregnancy?

Excessive salivation alone can have psychosocial consequences and also may lead to difficulty swallowing (dysphagia), which can lead to weight loss. In cases when the condition includes frequent vomiting, deficiencies of nutrients such as vitamin B1 (thiamine) can develop. This, in turn, can lead to a severe brain condition called Wernicke encephalopathy, featuring tiredness and confusion, dampened reflexes, and problems with movement, including movement of the eyes. In very extreme cases, Wernicke encephalopathy can be fatal. If recognized early, thiamine deficiency is easily curable.  Frequent vomiting also can lead to deficiencies of fat-soluble vitamins, such as vitamin K (which is important for blood clotting), so deficiency can lead to bleeding during pregnancy and severe bleeding during labor and delivery. The vomiting may lead to a particular type of acid-base disturbance called metabolic alkalosis, which causes or exacerbates a particular electrolyte disturbance called hypokalemia, low potassium. This can lead to muscle damage, kidney problems, and problems with the rhythm of the heart, which also can be fatal. Excessive vomiting and wretching can damage the esophagus badly enough to cause bleeding and entry of air into the tissues of and behind the chest.

Does excessive saliva during pregnancy cause problems for the baby?

In cases when the condition includes frequent vomiting, there is an increase in the rates of preterm birth and low birth weight, both of which can lead to physical and mental problems for the baby.

What to consider about taking medications when you are pregnant:

  • The risks to yourself and your baby if you do not treat the excessive saliva
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat excessive saliva during pregnancy?

Excessive salivation can be treated with medications that reduce salivation. Such medications include phenothiazines and various antihistamines, many of which also can be useful in treating nausea that often accompanies excessive salivation.

Who should NOT stop taking medication for excessive saliva during pregnancy?

If the medication is helping you by reducing your level of salivation, nausea, and vomiting, you should continue taking it.

What should I know about choosing a medication for excessive saliva during pregnancy?

You may find Pregistrys expert reports about the individual medications to treat excessive saliva here. Additional information can also be found in the sources listed at the end of this report.

What should I know about taking a medication for my excessive saliva when I am breastfeeding?

Generally, the excessive salivation resolves during the second half of pregnancy and thus is not an issue while you are breastfeeding.

What alternative therapies besides medications can I use to treat excessive saliva during pregnancy?

Its possible to manage the condition somewhat by drinking water frequently and using tissues to wipe the corner of your mouth.

What can I do for myself and my baby when I have excessive saliva during pregnancy?

You should cooperate with your physicians and take your medication as directed so that you can focus on delivering and caring for your baby.

Resources for excessive saliva in pregnancy:

For more information about excessive saliva during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:

 

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General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.


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