Evaluation of treatment of hyperemesis gravidarum using parenteral fluid with or without diazepam. A randomized study.
OBJECTIVE
Hyperemesis gravidarum is a relatively unknown disease, and is generally self-limiting. In some women the symptoms are so severe as to threaten the health of the mother and fetus. Therapies proposed for hyperemesis gravidarum are therefore rather empirical. Medical treatment includes parenteral fluid replacement and nutrition, electrolytes, antiemetics, vitamins, sedation and psychological counseling. Diazepam and benzodiazepines have been widely studied in pregnancy but the results are contradictory. The aim of the present study was to investigate the efficacy of parenteral fluids with vitamins, with or without diazepam sedation.


METHODS
Fifty women with hyperemesis gravidarum were enrolled in the study. They were treated with infusions of normal saline, glucose, vitamins and randomly with diazepam.


RESULTS
The results show that the mean stay in the hospital was shorter in the diazepam group: 4.5 +/- 1.9 vs. 6 +/- 1.6 days (p < 0.05) and readmission to the hospital was 4% in the diazepam group versus 27% in other group (p < 0.05). There was a significant reduction in nausea in the diazepam group (p < 0.05). A significant reduction in vomiting was observed in both groups. No side effects or congenital neonatal malformations were found in the diazepam group.


CONCLUSIONS
Intravenous administration of fluids and vitamins is the standard treatment for women hospitalized for hyperemesis gravidarum. The addition of diazepam to the treatment is effective in reducing nausea and does not have teratogenic effects.
Ditto
A
A
Department of Obstetrics and Gynecology, University of Siena, Italy.
Morgante
G
G
la Marca
A
A
De Leo
V
V
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use; D003975:Diazepam / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D006939:Hyperemesis Gravidarum / Q000628:therapy*; D017294:Ondansetron / Q000627:therapeutic use; D010288:Parenteral Nutrition; D010919:Placebos; D011247:Pregnancy; D014815:Vitamins / Q000008:administration & dosage
D000932:Antiemetics; D010919:Placebos; D014815:Vitamins; D017294:Ondansetron; D003975:Diazepam; D006854:Hydrocortisone