Management of nausea and vomiting in pregnancy

#### Summary points Nausea and vomiting are the most common symptoms of pregnancy. As a result many medical practitioners will encounter this problem and should be familiar with the appropriate investigations and current treatment options. Nausea and vomiting affect 50-90% of pregnant women, and in about 35% of these women symptoms are of clinical relevance, with both physical and psychosocial sequelae. Although colloquially referred to as “morning sickness,” for many women symptoms persist over the whole day, with a broad spectrum of severity ranging from occasional nausea to fulminant and intractable vomiting. Nausea and vomiting begin in the first trimester, at about six to eight weeks’ gestation, typically peaking at about nine weeks’ gestation and settling by about 12 weeks. Only a minority of women have symptoms after 20 weeks of gestation. Adequate oral hydration and avoidance of dietary triggers are often sufficient, but a proportion of women with severe and protracted nausea and vomiting will need antiemetic drugs. #### Sources and selection criteria We performed a PubMed search to identify peer reviewed original articles, meta-analyses, and reviews. Cochrane Collaboration and clinical evidence databases were reviewed as well. We considered only papers written in English and mainly included …