Advertisement

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.)
      To read this article in full you will need to make a payment

      References

        • Power ML
        • Holzman GB
        • Schulkin J.
        A survey on the management of nausea and vomiting in pregnancy by obstetrician/gynecologists.
        Prim Care Update Ob Gyns. 2001; 8: 69-72
        • O'Brien B
        • Naber S.
        Nausea and vomiting during pregnancy: effects on the quality of women's lives.
        Birth. 1992; 19: 138-143
        • Sahakian V
        • Rouse D
        • Sipes S
        • Rose N
        • Niebyl J.
        Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study.
        Obstet Gynecol. 1991; 78: 33-36
        • Vutyavanich T
        • Wongtra-ngan S
        • Ruangsri R-A.
        Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial.
        Am J Obstet Gynecol. 1995; 173: 881-884
        • Czeizel AE.
        Prevention of hyperemesis gravidarum is better than treatment.
        Am J Obstet Gynecol. 1996; 384: 1667
        • Emelianova S
        • Mazzotta P
        • Einarson A
        • Koren G.
        Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation.
        Clin Invest Med. 1999; 22: 106-110
        • Schuster K
        • Bailey LB
        • Dimperio D
        • Mahan CS.
        Morning sickness and vitamin B6 status of pregnant women.
        Human Nutr Clin Nutr. 1985; 39: 75-79
        • Jewel D
        • Young G.
        Interventions for nausea and vomiting of early pregnancy.
        Cochrane Data Base of Systematic Reviews. 2001; Vol 3
        • McKeigue PM
        • Lamm SH
        • Linn S
        • Kutcher JS.
        Bendectin and birth defects. I. A meta-analysis of the epidemiologic studies.
        Teratology. 1994; 50: 27-37
        • Neutel CI
        • Johansen HL.
        Measuring drug effectiveness by default: the case of Bendectin.
        Can J Public Health. 1995; 86: 66-69
        • Conklin FJ
        • Nesbitt Jr., REL
        Buclizine hydrochloride for nausea and vomiting of pregnancy.
        Obstet Gynecol. 1958; 11: 214-219
        • Czeizel AE
        • Dudas I
        • Fritz G
        • Tecsoi A
        • Hanck A
        • Kunovits G.
        The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy.
        Arch Gynecol Obstet. 1992; 251: 181-185
        • Oakley Jr., GP
        Let's increase folic acid fortification and include vitamin B-12.
        Am J Clin Nutr. 1997; 65: 1889-1890
        • Gardian G
        • Voros E
        • Jardanhazy T
        • Ungurean A
        • Vecsei L.
        Wernicke's encephalopathy induced by hyperemesis gravidarum.
        Acta Neurol Scand. 1999; 99: 196-198
        • Chataway J
        • Haradman E.
        Thiamine in Wernicke's syndrome-how much and how long?.
        Postgrad Med J. 1995; 71: 249-253
        • Mowrey DB
        • Clayson DE.
        Motion sickness, ginger and psychophysics.
        Lancet. 1982; 1: 655-657
        • Bone ME
        • Wilkinson DJ
        • Young JR
        • McNeil J
        • Charlton S.
        Ginger root: a new antiemetic. The effect of ginger root on post operative nausea and vomiting after major gynecologic surgery.
        Anesthesia. 1990; 45: 669-671
        • Vutyavanich T
        • Kraisarin T
        • Ruangsri R-A.
        Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial.
        Obstet Gynecol. 2001; 97: 577-582
        • Fischer-Rasmussen W
        • Kjaer SK
        • Dahl C
        • Asping U.
        Ginger treatment of hyperemesis gravidarum.
        Europ J Obstet Gynecol Reprod Biol. 1990; 38: 19-24