The safety of drugs for the treatment of nausea and vomiting of pregnancy

Abstract

Nausea and vomiting of pregnancy (NVP) is the most common medical condition of pregnancy, affecting up to 80% of all pregnancies to some degree. In most cases it subsides by the week 16 of pregnancy, although up to 20% of women continue to have symptoms throughout pregnancy. Severe NVP (Hyperemesis gravidarum) affects < 1% of women and in some severe cases can require hospitalization and rehydration of fluids. Women suffer not only physically but also psychologically, which has been documented in a number of studies. In addition, some women have decided to terminate their pregnancy rather than tolerate severe symptoms. Even less severe cases of NVP can have significant adverse effects on the quality of a woman's life, affecting her occupational, social, domestic functioning and general well being. Therefore, it is of great importance to treat this condition effectively to improve the quality of life for these women. In this paper, the authors review different classes of antiemetics used to treat this condition and discuss that some have better safety profiles than others, but most appear to be safe to use in pregnancy. Also included is a treatment algorithm that can assist the healthcare provider in treating this condition in pregnant safely and effectively.