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Nausea and Vomiting of Pregnancy

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11 papers 0 to 25 followers Future questioning medicine topic ??? #LECOM
Peng Chiong Tan, Pwint Phyu Khine, Narayanan Vallikkannu, Siti Zawiah Omar
OBJECTIVE: To compare the effects of promethazine with those of metoclopramide for hyperemesis gravidarum. METHODS: Women at their first hospitalization for hyperemesis gravidarum were approached when intravenous antiemetic therapy was needed. They were randomly assigned to receive 25 mg promethazine or 10 mg metoclopramide every 8 hours for 24 hours in a double-blind study. Primary outcomes were vomiting episodes by diary and well-being visual numerical rating scale score (10-point scale) in the 24-hour main study period...
May 2010: Obstetrics and Gynecology
Rasha S Bondok, Noha M El Sharnouby, Hala E Eid, Ahmed M Abd Elmaksoud
OBJECTIVE: Intractable hyperemesis gravidarum remains a serious cause of morbidity among pregnant women. If not controlled, hyperemesis gravidarum can lead to severe disability, electrolyte and acid base imbalance, and even various organ system dysfunctions. From the successful use of steroids for chemotherapy-induced emesis, corticosteroids might prove useful in hyperemesis gravidarum. The purpose of this study was to compare the efficacy of pulsed hydrocortisone therapy with that of metoclopramide for the management of intractable hyperemesis gravidarum...
November 2006: Critical Care Medicine
Gideon Koren
While perceived safe in pregnancy, several recent studies raise concerns about both fetal and maternal safety of ondansetron. Until more data are available, it should not be a first-line medication for morning sickness.
January 9, 2014: Therapeutic Drug Monitoring
Bengt Danielsson, Birgitta Norstedt Wikner, Bengt Källén
The study investigates teratogenic risks with ondansetron (Zofran(®)). Data from the Swedish Medical Birth Register combined with the Swedish Register of Prescribed Drugs were used to identify 1349 infants born of women who had taken ondansetron in early pregnancy, 1998-2012. Presence of congenital malformations in the offspring was identified with three national health registers. In a Mantel-Haenszel analysis adjustment was made for year of delivery, maternal age, parity, smoking in early pregnancy and pre-pregnancy body mass index...
December 2014: Reproductive Toxicology
Lauren G Oliveira, Shannon M Capp, Whitney B You, Robert H Riffenburgh, Shaun D Carstairs
OBJECTIVE: To evaluate whether ondansetron or the combination of doxylamine and pyridoxine was superior for the treatment of nausea and vomiting of pregnancy. METHODS: This was a double-blind, randomized, controlled trial in which women with nausea and vomiting of pregnancy were assigned to 4 mg of ondansetron plus a placebo tablet or 25 mg pyridoxine plus 12.5 mg of doxylamine for 5 days. The primary outcome was an improvement in nausea as reported on a 100-mm visual analog scale (VAS)...
October 2014: Obstetrics and Gynecology
Björn Pasternak, Henrik Svanström, Anders Hviid
BACKGROUND: Ondansetron is frequently used to treat nausea and vomiting during pregnancy, but the safety of this drug for the fetus has not been well studied. METHODS: We investigated the risk of adverse fetal outcomes associated with ondansetron administered during pregnancy. From a historical cohort of 608,385 pregnancies in Denmark, women who were exposed to ondansetron and those who were not exposed were included, in a 1:4 ratio, in propensity-score-matched analyses of spontaneous abortion (1849 exposed women vs...
February 28, 2013: New England Journal of Medicine
Anaïs Lacasse, Evelyne Rey, Ema Ferreira, Caroline Morin, Anick Bérard
OBJECTIVE: The only validated nausea and vomiting of pregnancy (NVP) severity index is the Motherisk Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) index that covers symptoms in the previous 12 hours. We sought to assess the validity of a modified-PUQE index that covers the entire first trimester of pregnancy by comparing NVP severity scores between the 12-hour PUQE index and our modified-PUQE index and by measuring the extent of the association between the modified-PUQE score and quality-of-life (QOL) score during the first trimester of pregnancy...
January 2008: American Journal of Obstetrics and Gynecology
Howard Ernest Herrell
Nausea and vomiting of pregnancy affects nearly 75% of pregnant women. The exact cause is unknown. In most cases, it is a mild, self-limited condition that can be controlled with conservative measures and has no adverse fetal sequelae. About 1% of women develop hyperemesis gravidarum, which may result in adverse outcomes for the mother and fetus. Patients with nausea and vomiting of pregnancy should be evaluated for other causes, particularly if symptoms are unremitting or presentation is atypical. Initial treatment is conservative and includes dietary changes, emotional support, and vitamin B6 supplementation...
June 15, 2014: American Family Physician
Gideon Koren, Shannon Clark, Gary D V Hankins, Steve N Caritis, Menachem Miodovnik, Jason G Umans, Donald R Mattison
OBJECTIVE: To evaluate the effectiveness of Diclectin (doxylamine succinate 10 mg-pyridoxine hydrochloride 10 mg, delayed-release preparation) as compared with placebo for nausea and vomiting of pregnancy. STUDY DESIGN: A randomized, double-blind, multicenter placebo controlled trial studying pregnant women suffering from nausea and vomiting of pregnancy, analyzed by intention to treat. Women received Diclectin (n = 131) or placebo (n = 125) for 14 days. Nausea and vomiting of pregnancy symptoms were evaluated daily using the pregnancy unique quantification of emesis scale...
December 2010: American Journal of Obstetrics and Gynecology
Gideon Koren
The US FDA approval in April 2013 of Diclegis®, the doxylamine-pyridoxine combination for morning sickness, is a major milestone, particularly since it is indicated for use in pregnancy and the FDA has labeled it a pregnancy category A drug the strongest evidence of fetal safety. After thirty years of being orphaned from an FDA-labeled drug for the most common medical condition in pregnancy, American women and their health care providers have a therapeutic solution that is likely to positively impact millions of women each year...
2013: Journal of Population Therapeutics and Clinical Pharmacology
Svetlana Madjunkova, Caroline Maltepe, Gideon Koren
Nausea and vomiting of pregnancy (NVP) affects up to 85 % of all pregnancies. Effective treatment can greatly improve a woman's quality of life, reduce the risk for maternal and fetal complications, and reduce healthcare costs. Unfortunately, many women receive either no pharmacological treatment or are recommended therapies for which fetal safety and efficacy have not been established. First-line treatment of NVP, as recommended by several leading healthcare and professional organizations, is the combination of doxylamine and pyridoxine...
June 2014: Paediatric Drugs
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