Ondansetron is the first indication for the treatment of vomiting and nausea during pregnancy
28/09/2018 - The information is contained in the new guidelines published by FEBRASGO
The Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO) has just published a new guideline for the treatment of Nausea and Vomiting in Pregnancy (NVG). The document helps doctors by presenting new data, studies and the best treatment options for emesis gravidarum, which afflicts the daily lives of around 85% of pregnant women.
The new guideline brings two main changes: the first deals with the importance of early intervention, since nausea and vomiting are considered normal symptoms of pregnancy and are often not treated correctly. And this delay can cause permanent damage to the fetus, as there is a metabolic imbalance, explains Dr. Antonio Cabral, Full Professor at UFMG and one of the authors of the guideline.
"Prompt treatment of GDV prevents serious and potentially irreversible situations from arising for the pregnant woman and her baby. Recent publications show that micronutrient deficiencies (minerals and vitamins) resulting from GVN can result in severe embryopathies and impaired neurodevelopment, as well as the emotional issues and trauma that a pregnancy with prolonged vomiting and nausea can cause mothers," explains Dr. Cabral.
The new guideline highlights ondansetron, which is now the first drug indication for the treatment of nausea and vomiting in pregnancy, because in addition to its effectiveness and low incidence of side effects, it is the only active ingredient with a study proving that it does not interfere with the neurodevelopment of babies, according to the study by Larrimer MB.
The substance is already the most widely used by pregnant women in the United States. It is estimated that in 2014 around 2.2 million pregnant women in the country (around 22% of the total) used ondansetron to control their GVHD. This increase has been referred to by some authors as the "escalation" of ondansetron. "The drugs currently available are all safe from the point of view of teratogenesis, but ondansetron, in particular, has also been shown to be safe in terms of not intervening in the future neurodevelopment of the child exposed to it during pregnancy. This safety is one of the main reasons for its widespread use around the world," says the doctor.
Febrasgo's new guideline also provides information on the concept and cause of nausea and vomiting in pregnancy and addresses hyperemesis gravidarum, when the condition becomes more serious. The document was drawn up by four specialists. In addition to Dr. Antonio Cabral, doctors Jorge Oliveira Vaz, Adjunct Professor IV of Gynecology and Obstetrics at UFPA; Geraldo Duarte, Full Professor at the Department of Gynecology and Obstetrics at USP's Ribeirão Preto School of Medicine; and Olímpio Moraes Filho, Adjunct Professor at the School of Medical Sciences at the University of Pernambuco took part in the project.