Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger☆

Abstract 

Patients suffering from nausea and vomiting of pregnancy (NVP) frequently do not receive therapy, in part because of fears of adverse effects of medications on the fetus. Several vitamin-based and herbal therapies have been shown to be effective and safe. Two randomized trials of vitamin B₆ have shown a benefit in reducing NVP. Women taking periconceptional multivitamins are less likely to have severe NVP. The combination of vitamin B₆ and doxylamine (previously marketed in the United States as Bendectin) has been shown to be safe for the fetus and effective in reducing NVP. Ginger was shown, in 2 studies, to reduce NVP. Vitamin B₁ (thiamine) deficiency can lead to Wernicke's encephalopathy in women with severe NVP. Replacement is needed for all women with vomiting of more than 3 weeks' duration. Prophylaxis with multivitamins and therapy with B₆, with or without doxylamine, are safe and effective therapies for NVP. (Am J Obstet Gynecol 2002;186:S253-5.)