Medication used in Nausea and Vomiting of Pregnancy - A Review of Safety and Efficacy
Posted on 30 May 2023
Nausea and vomiting are common symptoms experienced by 50– 90% of women in early pregnancy. ‘Morning sickness’ is a misnomer frequently used to describe nausea and vomiting in pregnancy (NVP), although the symptoms may persist the whole day and/or night. Pregnant women experience these symptoms mainly in the first trimester between 6 and 12 weeks of gestation, few of them continue till 20 weeks of gestation while in few others it continues throughout the pregnancy. The problem peaks at 9 weeks gestation, and approximately 60% of NVPs resolve by the end of the first trimester. In a very small minority of these patients, the symptoms become severe leading to dehydration, weight loss, excessive vomiting, and mandate hospital admission; this condition is known as Hyperemesis Gravidarum.
Given the uncertainty in the treatment of NVPs, both patients and healthcare practitioners often fear the use of antiemetic medications in pregnancy due to the potential risk to the fetus and mother. The manifestation of nausea and vomiting in pregnancy is different among each woman, so its management should be tailored similarly. Early treatment of nausea and vomiting is important and beneficial since it prevents a more severe form of occurring, or a possible hospitalization, and prevents both emotional and psychological problems. It is very important for the women and the healthcare providers to understand that a safe and effective NVP treatment benefits both the fetus and mother, thus all the treatment options should be open and considered.
Although most of the used medications are proven to be effective, there is a paucity of literature to support the safety and efficacy of pharmacological agents used to treat NVPs. However, the majority of findings revealed there is a lack of evidence associating prenatal antiemetic and birth defects. FDA approved the combination of pyridoxine-doxylamine was considered safe in pregnancy (Category A) and recommended as first-line therapy for NVPs
First published online on 11 Feb 2015 Copyright: © 2015 Thomas B, et al.Gynecol Obstet (Sunnyvale) 2015, 5:2