Comparing between Pyridoxine hydrochloride, Doxylamine Succinate/Pyridoxine Hydrochloride and Ondansetron for Treatment of Nausea and Vomiting in Pregnant Females

Background: Nausea and vomiting of pregnancy (NVP) is a common gestational condition, NVP affecting up to 80% of the pregnant women and are the third leading causes of maternal hospitalization during pregnancy. Many pregnant females, and even some healthcare professionals, dread using antiemetic drugs due to a false belief of their teratogenicity risk The majority of women with NVP can be treated with dietary and lifestyle changes, but more than one-third of patients experience clinically significant symptoms that may necessitate fluid and vitamin supplementation and/or antiemetic therapy such as, for example, pyridoxine hydrochloride, ondansetron, combined doxylamine/pyridoxine, which is not teratogenic and may be effective in managing NVP. Objectives: To compare the efficacy of pyridoxine hydrochloride, doxylamine succinate/pyridoxine, and ondansetron in alleviating nausea and vomiting in pregnancy.Methods: This randomized clinical trial included 300 pregnant women attending El-May Family Health Care Center, Menofia, from 1 January 2024 to 1 January 2025. Participants with mild to moderate NVP received one of the study medications for 5 days. Pre- and post-treatment questionnaires assessed changes in symptoms.Results: In cases of nausea and retching, doxylamine succinate/pyridoxine showed superior efficacy with statistically significant improvement compared to the other treatments. For vomiting in moderate NVP, ondansetron was more effective than the alternatives.Conclusions: Doxylamine succinate/pyridoxine is more effective than pyridoxine and ondansetron in managing mild NVP, whereas ondansetron is superior for moderate nausea and vomiting in pregnancy.