Home subcutaneous metoclopramide therapy for hyperemesis gravidarum

Abstract

OBJECTIVE: To describe the use of subcutaneous (s.c.) metoclopramide in the outpatient treatment of hyperemesis gravidarum. STUDY DESIGN: In a retrospective design, women who received continuous s.c. metoclopramide for treatment of hyperemesis gravidarum were identified from a national database. Data analysis included weight at start and stop of treatment, frequency of resolution of symptoms, and side effects of medication. In addition, data were collected on adjuvant therapies. RESULTS: Between January and December of 1997, there were 646 women with hyperemesis gravidarum who received continuous s.c. metoclopramide on an outpatient basis. A total of 413 patients (63.9%) had complete resolution of symptoms. Seventy-five percent of patients had received one or more antiemetic medications before initiation of s.c. metoclopramide. A total of 192 patients (30.5%) reported at least one side effect related to treatment. The majority of reported side effects were considered mild and did not require discontinuation of s.c. metoclopramide. CONCLUSION: S.c. metoclopramide appears to be a safe, effective treatment for hyperemesis gravidarum. Outpatient treatment may result in decreased costs compared with inpatient hospitalization.