Nausea and vomiting in early pregnancy

BMJ Clin Evid. 2009 Jun 3:2009:1405.

Abstract

Introduction: More than half of pregnant women suffer from nausea and vomiting, which typically begins by the 4th week and disappears by the 16th week of pregnancy. The cause of nausea and vomiting in pregnancy is unknown, but may be due to the rise in human chorionic gonadotrophin concentration. In 1 in 200 women, the condition progresses to hyperemesis gravidarum, which is characterised by prolonged and severe nausea and vomiting, dehydration, and weight loss.

Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatment for nausea and vomiting in early pregnancy? What are the effects of treatments for hyperemesis gravidarum? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

Results: We found 30 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupressure; acupuncture; antihistamines; corticosteroids; corticotrophins; diazepam; dietary interventions other than ginger; domperidone; ginger; metoclopramide; ondansetron; phenothiazines; and pyridoxine (vitamin B6).

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Acupressure
  • Administration, Oral
  • Domperidone* / therapeutic use
  • Female
  • Humans
  • Metoclopramide* / therapeutic use
  • Nausea / drug therapy
  • Phytotherapy
  • Pregnancy
  • Single-Blind Method
  • United States Food and Drug Administration
  • Vomiting / drug therapy

Substances

  • Domperidone
  • Metoclopramide