SOMANZ position paper on the management of nausea and vomiting in pregnancy and hyperemesis gravidarum

Abstract

This is a brief summary of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) evidence‐based guideline for the management of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG). The full guideline and executive summary including auditable outcomes are freely available on the SOMANZ website [://www.somanz.org/guidelines.asp]. The guideline includes a proposed SOMANZ definition of NVP and HG and evidence‐based practical advice regarding the investigation and management of NVP, HG and associated conditions including thyroid dysfunction. A practical algorithm for assessment and management as well as an individual patient management plan and self‐assessment tools are included.

Pregnant women report being denied medications to treat severe nausea and vomiting of pregnancy or hyperemesis gravidarum – findings from an Australian online survey

“…Our findings suggest an urgent need to identify and effectively address barriers to the provision of effective treatments for severe NVP and HG. The recently published national clinical practice guidelines by the Society of Obstetric Medicine of Australia and New Zealand for the management of severe NVP and HG seek to overcome many of these issues, 4 but significant efforts are required to improve provider training and facilitate implementation of these and other guidelines, particularly across primary health care settings. This requires a collaborative multidisciplinary approach involving consumer organisations, professional societies and government organisations.…”

“…Management of NVP/HG depends on symptom severity and their associated impacts on quality of life, as well as medication safety considerations. Guidelines for the treatment of NVP/HG all recommend step‐wise treatment of symptoms, commencing with non‐pharmacological interventions 4–7 . The majority of women experiencing severe NVP/HG require one or more medications to assist with symptom control 4 …”

“…Guidelines for the treatment of NVP/HG all recommend step‐wise treatment of symptoms, commencing with non‐pharmacological interventions 4–7 . The majority of women experiencing severe NVP/HG require one or more medications to assist with symptom control 4 …”

Response to Letter to the Editor 'Answering medication safety concerns in pregnancy – The difficulty for community pharmacists'

“…Pharmacists and other healthcare practitioners are encouraged to refer to other contemporaneous and freely accessible resources such as the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) evidence-based guideline for the management of NVP and hyperemesis gravidarum (HG). 4 The preclusion of medications available for management of NVP and HG based on the Product Information pregnancy warnings for 'sedating antihistamines' is an additional barrier to care for an already debilitating and misunderstood pregnancy condition. This is both misleading and confusing for consumers and can lead to 'less safe alternatives' when seeking treatment for NVP and HG.…”

Confusion about doxylamine safety in pregnancy

“…Furthermore, the Society of Obstetric Medicine of Australia and New Zealand’s practice guidelines recommend doxylamine (and pyridoxine) as first line treatment for NVP 4 …”