Managing nausea and vomiting of pregnancy: a survey of obstetrician-gynecologists.
OBJECTIVE
To assess obstetrician-gynecologists' treatment of nausea and vomiting of pregnancy and to compare it with recommendations in an American College of Obstetricians and Gynecologists (ACOG) evidence-based practice bulletin on the topic.


METHODS
A survey questionnaire was mailed to the 1075 ACOG fellows who constitute the Collaborative Ambulatory Research Network (CARN).


RESULTS
The most frequently recommended treatments for a patient with moderate to severe nausea with occasional vomiting were: eat frequent, small meals (93%); snack on soda crackers (68.5%); and take vitamin B6 plus doxylamine (67.1%). Two of 3 (66.7%) respondents had read the ACOG practice bulletin; most of those who had read it found it helpful (67.0%) or very helpful (29.5%). Respondents who read the practice bulletin were generally more willing to treat nausea and vomiting of pregnancy aggressively. They were more likely to be aware that early treatment is recommended to prevent progression to hyperemesis gravidarum and more likely to recommend the use of ginger (59.7% vs. 47.9%, p = 0.014), and to prescribe vitamin B6 (84.1% vs. 73.8%, p = 0.005) and vitamin B6 plus doxylamine (70.9% vs. 59.3%, p = 0.009).


CONCLUSIONS
Obstetrician-gynecologists' treatment and prescribing practices generally follow ACOG recommendations; the ACOG practice bulletin appears to have affected practice and knowledge.
Power
Michael L
ML
Research Department, American College of Obstetricians and Gynecologists, Washington, DC 20024, USA. mpower@acog.org
Milligan
Lauren A
LA
Schulkin
Jay
J
D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000517:prevention & control* / Q000628:therapy*; D008297:Male; D009325:Nausea / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014839:Vomiting / Q000628:therapy*