NAUSEA AND VOMITING IN PREGNANCY

UNIVERSITY of TARUMANAGARA
PERIOD 3 NOVEMBER - 22 NOVEMBER 2014
IRWAN DEPUTRA HAMDANI - 406138103

EPIDEMIOLOGY
About 50% of women have nausea and
vomiting in early pregnancy
Additional 25% have nausea alone
Also called morning sickness
The symptoms lead to dehydration and
weight loss

http://www.nejm.org/doi/full/10.1056/NEJMcp1003896

ETIOLOGY
Still unclear
Stimulus is produced by the placenta
Correlates closely with the level of human
chorionic gonadotropin (hCG) estrogen
nausea and vomiting
Vitamin B deficiency B1, B6, B12

http://www.nejm.org/doi/full/10.1056/NEJMcp1003896

MANAGEMENT
Pharmacology
Antihistamines:
Meclizine 25 mg every 4-6 hours
Dimenhydrinate orally or rectally 50-100 mg every 4-6
hours
Diphenhydramine 25-50 mg orally every 4-6 hours /
10-50 mg intravenously / intramuscularly every 4-6 hours
Metoclopramid:
5HT antagonis
Ondansetron 4-8 mg orally every 8 hours
http://www.medscape.com/viewarticle/545629_3
http://www.nejm.org/doi/full/10.1056/NEJMoa1211035#t=articleMethods
http://www.nejm.org/doi/full/10.1056/NEJMoa0807154#t=articleDiscussion

MANAGEMENT
Pharmacology
Dopamine antagonists:
Metoclopramide 5-10 mg orally or intravenously
every 6 hours
Prochlorperazine 5-10 mg orally or 10-25 mg
rectally every 6 hours
promethazine 12.5-25 mg every 4-6 hours orally or
rectally
http://www.medscape.com/viewarticle/545629_3
http://www.nejm.org/doi/full/10.1056/NEJMoa1211035#t=articleMethods
http://www.nejm.org/doi/full/10.1056/NEJMoa0807154#t=articleDiscussion

Corticosteroids
Methylprednisolone 48 mg/day in 3 divided
doses for 2-3 days
Supplement
Vit B:
B1 10 25 mg po / day
B6 20 -50mg po / day
B12 50 100 ug / day