Utilité du dropéridol et de la diphenhydramine dans l’hyperemesis gravidarum

Abstract

Objective: assess effects of the administration of droperidol and diphenhydramine for the treatment of hyperemesis gravidarum in regards to hospital stay, readmission rates and nausea and vomiting relief.Methods: non randomised, prospective study with an historical control of 54 patients receiving conventional anti-emetic treatment. The study group of 28 patients was treated with intravenous droperidol and diphenhydramine. Studied variables included duration of hospital stay, readmission rate, intensity of nausea and vomiting according to NCI scoring system, pregnancy outcomes and side effects.Study Site: Sainte-Justine’s Hospital in Montréal, Québec; a tertiary care university teaching hospital.Study Population: hospitalised patients diagnosed with hyperemesis gravidarum.Results: we observed a reduction in the duration of hospital stay (3,53 to 2,82 days; p = 0,023) and in readmission rates (38,9 to 14,3 percent; p = 0,025) in the droperidol/ diphenhydramine group in comparison to the historical group. The average daily nausea and vomiting scores were lower in the experimental group compared to the control group: 0,61 versus 1,47 (p < 0,001) and 0,23 versus 0,62 (p < 0,001), respectively. Most common side effects were sedation, dry mouth and hypotension. Extrapyramidal reactions were observed in six patients (22 percent). Pregnancy outcomes in the two groups were similar except for the number of caesarean sections which were higher in the group treated with droperidol/ diphenhydramine (32,0 vs 9,5 percent; p = 0,044).Conclusion: the administration of droperidol/diphenhydramine seems to be a promising alternative for the treatment of hyperemesis gravidarum. A large, prospective, randomised study is required to confirm maternal effectiveness together with foetal innocuity.