A survey of prescribing for the management of nausea and vomiting in pregnancy in Australasia

Raymond, Stephen H

doi:10.1111/ajo.12045

Cited by 17 publications

(19 citation statements)

References 7 publications

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“…This scenario is probably due to two main factors: (1) the predominantly mild character of nausea and the possibility of non-pharmacological management (eg, dietary advices) and (2) the reluctance of general practitioners to prescribe antinauseants even though safety profile assessments are in place 27 28. As also shown in previous studies,4 29 use of serotonin antagonists during pregnancy in North America and Australia is increasing compared with the other regions, eliciting the need of sound studies assessing the safety profile of this drug group in pregnancy.…”

Section: Discussionmentioning

confidence: 87%

Medication use in pregnancy: a cross-sectional, multinational web-based study

et al. 2014

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ObjectivesIntercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use.DesignCross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire.SettingMultinational study in Europe (Western, Northern and Eastern), North and South America and Australia.ParticipantsPregnant women and new mothers with children less than 1 year of age.Primary and secondary outcome measuresPrevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use.ResultsThe study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants.ConclusionsIn this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.

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Section: Discussionmentioning

confidence: 87%

Medication use in pregnancy: a cross-sectional, multinational web-based study

et al. 2014

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“…Apart from HG, consideration should be given to other underlying complications associated with persistent vomiting, such as gastrointestinal conditions (eg, hepatitis, pancreatitis, or biliary tract disease), pyelonephritis, and metabolic disorders (eg, diabetic ketoacidosis, porphyria, or Addison’s disease) 55. If such conditions are ruled out, adherence to obstetrical guidelines for the management of nausea and vomiting in pregnancy is encouraged,55–58 although disconcertingly, this may not always be followed in practice 59…”

Section: Identification and Treatment Of Hgmentioning

confidence: 99%

Hyperemesis gravidarum: current perspectives

McCarthy¹,

Lutomski²,

Greene³

2014

IJWH

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“…It is only available as a subsidised medicine under the PBS with an “authority required, management of nausea and vomiting associated with radiotherapy being used to treat malignancy,” or as a “restricted benefit—can only be prescribed for specific therapeutic uses, management of nausea and vomiting associated with cytotoxic chemotherapy being used to treat malignancy which occurs within 48 hours of chemotherapy administration [18]. ” A recent survey of the management of NVP by obstetricians in Australia found that off-label use of ondansetron in NVP is clearly widespread [19]. In addition to concerns about patient safety, ondansetron is much more expensive than older medications and its use raises the issue of cost both to the patient and the health system in general.…”

Section: Introductionmentioning

confidence: 99%

Off-Label Use of Ondansetron in Pregnancy in Western Australia

Colvin

Gill

Slack‐Smith

et al. 2013

BioMed Research International

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Aims. Nausea and vomiting of pregnancy is the most common medical condition in pregnancy. There is an increasing trend to prescribe ondansetron although its safety for use in pregnancy has not been established. Methods. Exposed pregnancies were all births in Western Australia, 2002–2005, where the mother was dispensed ondansetron under the Australian Pharmaceutical Benefits Scheme, compared with all other births during the same period. Outcomes investigated include maternal and child characteristics, birth defects, pregnancy, and delivery characteristics. Results. There were 96,968 births from 2002 to 2005. Ondansetron was dispensed to 251 pregnant women during this period. The women dispensed ondansetron were more likely to be privately insured (OR: 5.8; 95% CI: 4.3–7.9), to be Caucasian (3.3; 1.9–5.7), not to smoke during their pregnancy (2.9; 1.8–4.7), to have a multiple birth (2.7; 1.5–5.0), and to have used fertility treatment (1.8; 1.0–3.4). There was a small but not significantly increased risk of a major birth defect with first trimester exposure (1.2; 0.6–2.2). Conclusions. Our study did not detect any adverse outcomes from the use of ondansetron in pregnancy but could not conclude that ondansetron is safe to use in pregnancy.

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A survey of prescribing for the management of nausea and vomiting in pregnancy in Australasia

Abstract: Despite guidelines suggesting the use of antihistamines and dopamine agonists (phenothiazines), very few practitioners in this region make use of these in any numbers.

Cited by 17 publications

References 7 publications

Medication use in pregnancy: a cross-sectional, multinational web-based study

Medication use in pregnancy: a cross-sectional, multinational web-based study

Hyperemesis gravidarum: current perspectives

Off-Label Use of Ondansetron in Pregnancy in Western Australia

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