5-HT3 Antagonist for Pregnancy Associated Nausea and Vomiting

  • Sumit Ghosh
  • Nirankar Dev
  • David Matthews
Keywords: Pregancy, Nausea, Vomiting

Abstract

5-HT3 antagonists appear to be an effective treatment option in the treatment of nausea and vomiting associated with pregnancy. Literature suggests an increased risk of congenital defects in fetuses exposed to ondansetron during pregnancy, especially during first trimester. Health authorities now suggest that this drug should not be used during this period. However, this decision is debatable and whether ondansetron can be used in pregnant women is still controversial.

Downloads

Download data is not yet available.

Author Biographies

Sumit Ghosh

MBBS, Consultant Practitioner, Daryaganj, New Delhi

Nirankar Dev

MD (Gynaecology), Indore, M.P., India

David Matthews

M.Pharm, Private Consultant, Chennai, India

References

Einarson TR, Piwko C, Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J Popul Ther Clin Pharmacol. 2013;20(2):e171–83.

Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: a prospective study of its frequency, intensity, and patterns of change. Am J Obstet Gynecol. 2000;182(4):931–7.

Tan A, Lowe S, Henry A. Nausea and vomiting of pregnancy: effects on quality of life and day-to-day function. Aust N Z J Obstet Gynaecol. 2018;58(3):278–90.

Campbell K, Rowe H, Azzam H, Lane CA. The management of nausea and vomiting of pregnancy. J Obstet Gynaecol. 2016;38(12):1127–37.

Royal College of Obstetricians Gynaecologists. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum. Green-top Guideline No.69; 2016.

Committee on Practice Bulletins-Obstetrics. ACOG practice bulletin No. 189: nausea and vomiting of pregnancy. Obstet Gynecol. 2018;131(1):e15–30.

Meyer A, Fermaut M, Drouin J, Carbonnel F, Weill A. Drug use for gastrointestinal symptoms during pregnancy: a French nationwide study 2010–2018. PloS One 2021;16(1):e0245854.

Parker SE, Van Bennekom C, Anderka M, Mitchell AA, National Birth Defects Prevention Study. Ondansetron for treatment of nausea and vomiting of pregnancy and the risk of specific birth defects. Obstet Gynecol. 2018;132(2):385–94.

Huybrechts KF, Hernandez-Dıaz S, Straub L, Gray KJ, Zhu Y, Patorno E, et al. Association of maternal first-trimester ondansetron use with cardiac malformations and oral clefts in offspring. JAMA 2018;320(23):2429–37. https://doi.org/10.1001/jama.2018.18307

Updated Signal assessment report on birth defects following in-utero exposure during the first trimester of pregnancy arising from recent publications with ondansetron; 2019. (Online PDF). Available from: https://www.ema.europa.eu/en/documents/prac-recommendation/updated-signal-assessment-report birth-defects-following-utero-exposure-during-first-trimester_en.pdf]. [Last Accessed on 15th August, 2021]

Picot C, Berard A, Grenet G, Ripoche E, Cucherat M, Cottin J. Risk of malformation after ondansetron in pregnancy: an updated systematic review and metaanalysis. Birth Defects Res 2020;112(13):996–1013. https:// doi.org/10.1002/bdr2.1705

Zambelli-Weiner A, Via C, Yuen M, Weiner DJ, Kirby RS. First trimester ondansetron exposure and risk of structural birth defects. Reprod Toxicol Elmsford N. 2019;83:14–20.

Lemon LS, Bodnar LM, Garrard W, Venkataramanan R, Platt RW, Marroquin OC, et al. Ondansetron use in the first trimester of pregnancy and the risk of neonatal ventricular septal defect. Int J Epidemiol. 2020;49(2):648–56. https:// doi.org/10.1093/ije/dyz255

Huybrechts KF, Hernandez-Diaz S, Straub L, Gray KJ, Zhu Y, Mogun H, et al. Intravenous ondansetron in pregnancy and risk of congenital malformations. JAMA 2020;323(4):372–4. https://doi.org/10.1001/jama.2019.18587.

Berard A, Sheehy O, Gorgui J, Zhao J-P, Soares de Moura C, Bernatsky S. New evidence for concern over the risk of birth defects from medications for nausea and vomiting of pregnancy. J Clin Epidemiol. 2019;116:39–48. https://doi.org/10.1016/j.jclinepi.2019.07.014

Dormuth CR, Winquist B, Fisher A, Wu F, Reynier P, Suissa S, et al. Comparison of pregnancy outcomes of patients treated with ondansetron vs. alternative antiemetic medications in a multinational. Population-based cohort. JAMA Netw Open. 2021;4(4):e215329. https://doi.org/10.1001/jamanetworkopen.2021.5329

Damkier P, Kaplan YC, Shechtman S, Diav-Citrin O, Cassina M, Weber-Schoendorfer C, et al. Ondansetron should never be used in pregnancy: against: ondansetron in pregnancy revisited. BJOG Int J Obstet Gynaecol. 2021;128(1):111–2. https:// doi.org/10.1111/1471-0528.16476

Vabre C, Araujo M, Damase-Michel C et al., Initial data on the safety of metopimazine during pregnancy and the risk of birth defects and pregnancy loss - An observational study using the EFEMERIS database, Therapies, https://doi.org/10.1016/j.therap.2021.09.006.

CITATION
DOI: 10.26440/IHRJ/0509.12485
Published: 2021-12-30
How to Cite
1.
Sumit Ghosh, Nirankar Dev, David Matthews. 5-HT3 Antagonist for Pregnancy Associated Nausea and Vomiting. IHRJ [Internet]. 2021Dec.30 [cited 2022May28];5(9):RV9-RV11. Available from: https://ihrjournal.com/ihrj/article/view/485