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

BACKGROUND: There is an impression of poor management of pregnancy sickness in Australia, specifically an apparent total reliance on metoclopramide, as a first-line choice. AIMS: To determine what management options are commonly used in by distributing a survey to Fellows and Diplomates of RANZCOG. METHODS: A web-based survey questionnaire distributed using an email list obtained from RANZCOG. RESULTS: A total of 495 responses were received (23%). For morning sickness, 89% of those replying give dietary advice frequently or always, and 70% prescribe metoclopramide frequently or always, whereas 59% advise pyridoxine and 10% prescribe doxylamine. For hyperemesis gravidarum, 86% prescribe metoclopramide and 75% ondansetron. CONCLUSIONS: Despite guidelines suggesting the use of antihistamines and dopamine agonists (phenothiazines), very few practitioners in this region make use of these in any numbers.