BMJ 2011: 342: 1371 – 1428 (25th June)

When treating women with hyperemesis gravidarum, check the urine for ketones.  Ketonuria is a danger sign, as is vomiting >5x/day and/or failure to drink at least 500 ml/day.  Low-risk reatments include acupressure, pyridoxine, metoclopramide, domperidone, prochlorperazine, chlorpromazine 10 – 25 mg up to tds, promethazine 25 mg nocte, or ondasetron 4 – 8mg bd to tds.  Huge meta-analysis (abstract here) looks at safety of the different ones in pregnancy.


About Dr Sarah

I'm a GP with a husband and two young children.
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