Ondansetron Compared with Doxylamine and Pyridoxine for Treatment of Nausea and Vomiting in Pregnancy

Yahia, Mohamed Kamal; Khattab, Khattab Khattab Abdelhalim Omar; Hamed, Alaa Ebrahim

doi:10.21608/ijma.2020.26371.1111

Ondansetron Compared with Doxylamine and Pyridoxine for Treatment of Nausea and Vomiting in Pregnancy

Document Type : Original Article

Authors

¹ Department of Obstetrics and Gynecology, Damietta General Hospital, Ministry of Health, Egypt

² Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt

10.21608/ijma.2020.26371.1111

Abstract

Background: Nausea and vomiting affects up to 80% of the pregnant women population and are the third leading causes of maternal hospitalization during pregnancy. Many pregnant females, and even some healthcare professionals, dread using antiemetic drugs due to a false beliefof their teratogenicrisk.
Aim of the work:This study aimed to evaluate ondansetron to a combination of doxylamine and pyridoxine in controlling pregnancy-related nausea and vomiting.
Patients and Methods:This randomized controlled trial included 156 pregnant women, at 16 weeks of gestation, with mild-to-moderate nausea and vomiting. Meanwhile, women with severe symptoms indicating admission, those already on anti-emetics, and those who wouldn’t be able to show up for follow-up visits were excluded. Seventy-eight patients received intravenous injection of ondansetron [Zofran] at a dose of 8 mg once daily for 5 days, whereas the other 78 patients received oral pyridoxine at a dose of 25 mg plus doxylamine at a dose of 12.5 mg [Diclegis] twice daily for 5 days. Each patient was subjected to full history taking, complete clinical examination and investigations.
Results: Women on Ondansetron reported better alleviation of nausea compared to those receiving pyridoxine and doxylamine [96.2% vs. 52.6%, P<0.001, respectively]. The most frequently reported side effects were headache, dry mouth, gastrointestinal [GI] disturbances, and abdominal pain, and the differences in their occurrence between the two groups were statistically insignificant.
Conclusion: Ondansetron was found superior to the combination of pyridoxine and doxylamine in improving pregnancy-related nausea and vomiting occurring without a significant increase in side effects.

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