Nausea and vomiting in pregnancy remain one of the most persistent and frustrating problems for both expectant mothers and their prenatal care providers. Forty percent or more of women will experience symptoms beyond the first trimester. Evidence for first-line pharmacologic treatments as well as off-label and botanical medicines is discussed, along with efficacy, risks, benefits, and the shared decision-making process in selecting a treatment. Outcomes, prognosis, and treatment of special populations are examined.
Learning Objectives:
Objective 1: List three factors that must be assessed to determine the severity of the woman’s nausea and vomiting in order to guide the treatment goals.
Objective 2: Identify a barrier to use of combination doxylamine succinate and pyridoxine tablets.
Objective 3: List three pharmaceuticals in the antihistamine category that are commonly used to treat nausea and vomiting in pregnancy, and discuss their safety profiles.
Objective 4: List three classes of dopamine antagonists used for nausea and vomiting in pregnancy and the maternal side affects associated with them.
Objective 5: Describe three risk factors associated with serotonin antagonists.
Objective 6: Describe management of the hypovolemic client with nausea and vomiting.
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