Severe nausea and vomiting of pregnancy: should it be treated with appropriate pharmacotherapy?

Abstract

Key content: • Severe nausea and vomiting occurs in up to 30% of pregnant women and it can cause significant morbidity. • There are over 25 000 admissions per year for hyperemesis gravidarum in England. • Safe, effective treatments for severe nausea and vomiting of pregnancy are available. • Early treatment is important to prevent the development of hyperemesis gravidarum. • Treatment algorithms have been developed in other countries. Learning objectives: • To recognise that severe nausea and vomiting of pregnancy often occurs after midday, so the term 'morning sickness' is inappropriate. • To increase knowledge of the evidence for safe, effective treatment of the condition. • To understand that effective management is important. Ethical issues: • There are concerns about teratogenicity when prescribing pharmacological therapy: severe pregnancy sickness may, therefore, go untreated. • Lack of treatment may be associated with increased admissions for hyperemesis gravidarum.