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2014 ; 2014
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Nausea and vomiting in early pregnancy
#MMPMID24646807
Festin M
BMJ Clin Evid
2014[Mar]; 2014
(ä): ä PMID24646807
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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).
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