Nausea and vomiting in early pregnancy

Overview

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Substantive changes at this update

Acupressure for treating nausea and vomiting in early pregnancy: New evidence added.[14][15][16] Categorisation unchanged (likely to be beneficial).

Promethazine for treating nausea and vomiting in early pregnancy: Previous option on antihistamines restructured to only report promethazine. Existing evidence re-evaluated. Categorised as unknown effectiveness.

Ginger for treating nausea and vomiting in early pregnancy: One systematic review updated.[12] New evidence added.[23][24][25] Categorisation unchanged (likely to be beneficial).

Pyridoxine (vitamin B6) for treating nausea and vomiting in early pregnancy: One systematic review updated.[12] Categorisation unchanged (likely to be beneficial).

Acupuncture for treating nausea and vomiting in early pregnancy: One systematic review updated.[12] Categorisation unchanged (unknown effectiveness).

Metoclopramide for treating nausea and vomiting in early pregnancy: New evidence added.[25] Categorisation unchanged (unknown effectiveness).

Prochlorperazine for treating nausea and vomiting in early pregnancy: One systematic review updated. Option restructured from phenothiazines to only include prochlorperazine. Categorisation unchanged (unknown effectiveness).

Acupressure for treating hyperemesis gravidarum: New evidence added.[14][15] Categorisation changed from likely to be beneficial to unknown effectiveness.

Ondansetron for treating hyperemesis gravidarum: New evidence added.[43] Categorisation unchanged (unknown effectiveness).

Abstract

INTRODUCTION: More than half of pregnant women suffer from nausea and vomiting, which typically begins by the fourth 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 September 2013 (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 32 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; corticosteroids; ginger; metoclopramide; ondansetron; prochlorperazine; promethazine; and pyridoxine (vitamin B6).

Cite as

Festin M. Nausea and vomiting in early pregnancy. Systematic review 1405. BMJ Clinical Evidence. . 2014 March. Accessed [date].

Latest guidelines

Latest citations

Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment. ( 10 January 2017 )

Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy: A Systematic Review. ( 10 January 2017 )