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Comparison of Three Outpatient Regimens in the Management of Nausea and Vomiting in Pregnancy

Abstract

OBJECTIVE: This study compares pyridoxine–metoclopramide combination therapy to prochlorperazine and promethazine monotherapies in the outpatient treatment of nausea and vomiting in pregnancy.

STUDY DESIGN: In total, 174 first trimester, singleton pregnancies were evaluated for nausea and vomiting. Patients were prospectively randomized into three treatment groups: pyridoxine–metoclopramide, prochlorperazine, or promethazine. Prior to, and on the third day, patients recorded their subjective responses to the given treatment and their number of emesis episodes. The three treatment groups were compared for therapy response.

RESULTS: There were no differences in the number of emesis episodes prior to treatment. Both subjective and objective responses to treatment differed among the three groups when comparing the combination therapy to the monotherapies (p<0.05).

CONCLUSION: Combination therapy with pyridoxine and metoclopramide appears to be superior to either monotherapy in the treatment of nausea and vomiting in pregnancy.

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References

  1. Jewell D, Young G . Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2002;CD000145.

  2. Klebanoff MA, Koslowe PA, Kaslow R, et al. Epidemiology of vomiting in early pregnancy. Obstet Gynecol 1985;66:612–616.

    CAS  PubMed  Google Scholar 

  3. Depue RH, Bernstein L, Ross RT, et al. Hyperemesis gravidarum in relation to estradiol levels, pregnancy outcome, and other maternal factors: a seroepidemiologic study. Am J Obstet Gynecol 1987;156:1137–1141.

    Article  CAS  Google Scholar 

  4. Nageotte MP, Briggs GG, Towers CV, et al. Droperidol and diphenhydramine in the management of hyperemesis gravidarum. Am J Obstet Gynecol 1996;174:1801–1805; discussion 1805–6.

    Article  CAS  Google Scholar 

  5. Sahakian V, Rouse D, Sipes S, et al. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study. Obstet Gynecol 1991;78:33–36.

    CAS  PubMed  Google Scholar 

  6. Briggs GG . A guideline for treating hyperemesis gravidarum. Contemporary OB/GYN 1997;42:70–79.

    Google Scholar 

  7. Attard CL, Kohli MA, Coleman S, et al. The burden of illness of severe nausea and vomiting of pregnancy in the United States. Am J Obstet Gynecol 2002;185:S220–S227.

    Article  Google Scholar 

  8. Prenatal care. In: Cunningham FG, Gant NF, Leveno KJ, Gilstrap III LC, Hankins GDV, Clark SL, editors. Williams Obstetrics, 20th edition. Stamford: Appleton & Lange; 1997. p. 227–250.

  9. Gadsby R, Barnie-Adshead AM, Jagger C . A prospective study of nausea and vomiting during pregnancy. Br J Gen Pract 1993;43:245–248.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Soules MR, Hughes Jr CL, Garcia JA, et al. Nausea and vomiting of pregnancy: role of human chorionic gonadotropin and 17-hydroxyprogesterone. Obstet Gynecol 1980;55:696–700.

    CAS  PubMed  Google Scholar 

  11. Goldzieher JW, Moses LE, Averkin E, et al. A placebo-controlled double-blind crossover investigation of the side effects attributed to oral contraceptives. Fertil Steril 1971;22:609–623.

    Article  CAS  Google Scholar 

  12. Deuchar N . Nausea and vomiting in pregnancy: a review of the problem with particular regard to psychological and social aspects. Br J Obstet Gynaecol 1995;102:106–108.

    Google Scholar 

  13. Sherman PW, Flaxman SM . Nausea and vomiting of pregnancy in an evolutionary perspective. Am J Obstet Gynecol 2002;185:S190–S197.

    Article  Google Scholar 

  14. Willis RS, Morris AT, Newsom AA, et al. Clinical observations in treatment of nausea and vomiting in pregnancy with vitamin B1 and B6. A preliminary report. Am J Obstet Gynecol 1942;44:265–271.

    Article  Google Scholar 

  15. Heller S, Salkeld RM, Korner WF . Vitamin B6 status in pregnancy. Am J Clin Nutr 1973;26:1339–1348.

    Article  CAS  Google Scholar 

  16. Niebyl JR, Goodwin TM . Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger. Am J Obstet Gynecol 2002;185:S253–S255.

    Article  Google Scholar 

  17. Vutyavanich T, Wongtra-ngan S, Ruangsri R . Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 1995;173:881–884.

    Article  CAS  Google Scholar 

  18. Van Thiel DH, Gavaler JS, Joshi SN, et al. Heartburn of pregnancy. Gastroenterology 1977;72:666–668.

    CAS  PubMed  Google Scholar 

  19. Kumar D . In vitro inhibitory effect of progesterone on extrauterine human smooth muscle. Am J Obstet Gynecol 1962;84:1300.

    Article  Google Scholar 

  20. Vella L, Francis D, Houlton P, et al. Comparison of the antiemetics metoclopramide and promethazine in labour. Br Med J (Clin Res Ed) 1985;290:1173–1175.

    Article  CAS  Google Scholar 

  21. Magee LA, Mazzotta P, Koren G . Evidence-based view of safety and effectiveness of pharmacologic therapy for nausea and vomiting of pregnancy (NVP). Am J Obstet Gynecol 2002;185:S256–S261.

    Article  Google Scholar 

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Bsat, F., Hoffman, D. & Seubert, D. Comparison of Three Outpatient Regimens in the Management of Nausea and Vomiting in Pregnancy. J Perinatol 23, 531–535 (2003). https://doi.org/10.1038/sj.jp.7210986

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