Managing Morning Sickness: Can We Be Systematic?

Many pregnant women will experience nausea and vomiting, generally in the first trimester. While not all will find the condition debilitating enough to require therapy, for those with more-severe symptoms, efficacious approaches often remain elusive. In a systematic review encompassing data from some 9000 women, the authors delineate severity-specific effective treatments based on available comparative studies. Highlights are as follows:

Mild Symptoms

• Ginger (commonly 250 mg orally every 6 hours)

• Vitamin B6 (10–25 mg orally every 8 hours)

• Acupressure (inner wrist [P6]); benefits of acupuncture and nerve stimulation are unclear.

Moderate Symptoms

• Antihistamines (e.g., hydroxyzine 25 mg orally twice daily, doxylamine 10 mg plus pyridoxine 10 mg eve…