Ondansetron substance is the first recommendation for the treatment of vomiting and nausea during pregnancy

Sogirgs Portal | 09/28/2018
Information contained in the new guideline 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 during pregnancy (HG). The document helps physicians by presenting new data, studies and the best treatment options for hyperemesis gravidarum, which afflicts the daily lives of about 85% of pregnant women.

The new guideline introduces two key changes: the first deals with the importance of early intervention. The issue is often not treated correctly because nausea and vomiting are considered normal symptoms of pregnancy. This delay can cause permanent damage to the fetus due to the metabolic imbalance that occurs, explains Dr. Antonio Cabral, Full Professor at Minas Gerais University (UFMG) and one of the authors of the guideline.

"The immediate treatment of HG prevents the occurrence of serious and potentially irreversible situations for the pregnant woman and her baby. Recent publications show that micronutrient (minerals and vitamins) deficiency due to HG can result in severe embryopathies and neurodevelopment impairment, as well as the emotional and traumatic issues that a gestation with vomiting and prolonged nausea can cause to mothers," explains Dr. Cabral.

The new guideline highlights ondansetron, which is the first drug recommended for the treatment of nausea and vomiting during pregnancy. Besides its effectiveness and low side effect incidence, it is the only active substance proven not to interfere in the neurodevelopment of infants, according to a study by Larrimer MB.

It is already the most widely used substance by pregnant women in the United States. It is estimated that in 2014, around 2.2 million pregnant women (nearly 22% of the total) used ondansetron to control HG. This increase was called an ondansetron "surge" by some authors. "Drugs available at the moment are all safe from the point of view of teratogenesis, but ondansetron in particular has also been shown to be safe for a child exposed to it during gestation by not interfering with future neurodevelopment. This safety is one of the main reasons for its expanded use worldwide," states the doctor.

FEBRASGO's new guideline also provides information on the characteristics and reasons for nausea and vomiting in pregnancy and addresses hyperemesis gravidarum as the condition becomes more severe. The document was produced by four experts. In addition to Dr. Antonio Cabral, the project also included doctors Jorge Oliveira Vaz, Assistant Professor IV of Gynecology and Obstetrics at Pará University (UFPA); Geraldo Duarte, Tenured Professor of the Department of Gynecology and Obstetrics, Medical School of Ribeirão Preto, São Paulo University (USP); and Olímpio Moraes Filho, Assistant Professor at the Faculty of Medical Sciences of Pernambuco University.
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