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The Management of Nausea and Vomiting of Pregnancy

Synthesis of National Guidelines

Tsakiridis, Ioannis, MSc*; Mamopoulos, Apostolos, PhD; Athanasiadis, Apostolos, PhD; Dagklis, Themistoklis, PhD§

Obstetrical & Gynecological Survey: March 2019 - Volume 74 - Issue 3 - p 161–169
doi: 10.1097/OGX.0000000000000654

Importance Nausea and vomiting of pregnancy (NVP) affects a high proportion of the pregnant population.

Objective The aim of this study was to compare and synthesize recommendations from national guidelines regarding the management of NVP.

Evidence Acquisition A descriptive review of 3 recently published national guidelines on NVP was conducted: Royal College of Obstetricians and Gynaecologists on “The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum,” American College of Obstetricians and Gynecologists on “Nausea and Vomiting of Pregnancy,” and Society of Obstetricians and Gynaecologists of Canada on “The Management of Nausea and Vomiting of Pregnancy.” These guidelines were summarized and compared in terms of the recommended management of pregnant women. The quality of evidence was also reviewed based on the method of reporting.

Results Several differences were identified on the different guidelines regarding the management of NVP. Frequent small meals and avoidance of iron supplements are recommended for prevention. The consumption of ginger, acustimulations, antihistamines, phenothiazines, dopamine, and serotonin 5-hydroxytryptamine type 3 receptor antagonists is routinely recommended for use in the community as treatment.

Conclusions Evidence-based medicine may lead to the adoption of an international guideline for the management of NVP, which may lead to a more effective management of that entity.

Target Audience Obstetricians and gynecologists, family physicians.

Learning Objectives After participating in this activity, the learner should be better able to synthesize management recommendations in cases of NVP; assess the preventive and nonpharmacologic regimens in cases of NVP; and propose the necessary pharmacologic treatment in cases of NVP.

*Resident Assistant,

Associate Professor,

Professor, and

§Consultant in Maternal-Fetal Medicine, Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

All authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity.

Correspondence requests to: Ioannis Tsakiridis, MSc, Konstantinoupoleos 49, 54642, Thessaloniki, Greece. E-mail:

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