Nausea and vomiting in pregnancy | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Please note that this guideline is only for use in pregnant women in the first trimester (up to 13+6 gestation) and those presenting for the first or second time. If the women are 14+ weeks gestation or presenting with the same symptoms for the third or more time, please refer directly to OBGYN medical staff at DGRI.

Points in history and examination

Rule out other causes:

Peptic ulcer
Cholecystitis
Gastroenteritis
Hepatitis
Pancreatitis
UTI
Metabolic
Neurological
Drug induced

Perform urinalysis

<2+ ketones

If tolerating oral fluids and no contraindications or allergies arrange outpatient management with oral anti-emetic.

Arrange face to face or telephone review after 48 hours.

First line

Cyclizine 50mg 8 hourly
Prochlorperazine 5-10mg 6-8 hourly
Promethazine 12.5-25mg 4-8 hourly
Chlorpromazine 10-25mg 4-6 hourly

Second line

Metoclopramide 5-10mg 8 hourly
Domperidone 10mg 8 hourly
Ondansetron 2-8mg 6-8 hourly (Avoid in first trimester)

2+ or more ketones

Refer to maternity assessment unit.

References

RCOG 2016 The management of nausea and vomiting of pregnancy and hyperemesis gravidarum (Green-top Guideline No.69) Full text