Secular Trends in the Treatment of Hyperemesis Gravidarum

ABSTRACT

The purpose of this study was to describe the treatment of women with hyperemesis gravidarum (HG). Women with HG pregnancies of at least 27 weeks duration occurring between 1985 and 2004 described their treatment on an HG website from 2003 to 2005. The usage and effectiveness of > 20 treatment options were reported by 765 women for 1193 pregnancies. The women who used intravenous (IV) hydration, serotonin inhibitors, and parenteral nutrition (PN) reported the highest rates of effectiveness, with 84%, 83%, and 79% reporting that these respective treatments may have contributed to decreased nausea/vomiting. The use of conventional treatments increased from 20 to 30% to > 60% between 1985 and 1989 and 2000 and 2004; serotonin inhibitor use increased to 55% after its introduction in the 1990s. Over the past 20 years, multiple treatments have been used for women with HG, with a trend toward treatment with reportedly more effective modalities, such as IV hydration and serotonin inhibitors.

Hyperemesis gravidarum - nausea - vomiting - pregnancy

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APPENDIX

Did the following treatments decrease or eliminate your nausea and vomiting? (Please answer: “Not offered” for all treatments that were not offered to you, “Effective” for all treatments that helped your symptoms, “Not effective” for treatments you tried that did not help, “Maybe” for all treatments you tried that might have helped, and “Not tried” for all treatments you did not try but were offered. Using the option of “Not tried” allows us to know if a treatment is being offered, but women are not trying it.)

List of Medications and Treatments: These are equivalent to the medications and treatments listed in Tables [1] and [2].

0 Some data in this paper were presented in preliminary form at the 55th Annual Clinical Meeting of American College of Obstetricians and Gynecologists, May 5-9, 2007, San Diego, CA (Obstet Gynecol 2007;109(4):1195S-1956S).