Warning Warning: This guideline is 161 day(s) past its review date.

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.

Rule out other causes:

  • Peptic ulcer
  • Cholecystitis
  • Gastroenteritis
  • Hepatitis
  • Pancreatitis
  • UTI
  • Metabolic
  • Neurological
  • Drug induced

Perform urinalysis

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)

Refer to maternity assessment unit.

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

Editorial Information

Next review date: 31/10/2024

Author(s): Emily Anderson.