The Clinical Practices Guidelines were reviewed by several expert organizations and approved by the Board of the Society of Obstetricians and Gynaecologists of Canada.

The first recommendation for curing morning sickness was discontinuing iron-containing prenatal vitamins during the first trimester and substituting them with folic acid or vitamins low in iron.

Other recommendations included acupressure, ginger, and mindfulness-based cognitive therapy.

In the past, women were told to eat small, bland meals and avoid fatty foods — but experts say there is little evidence that dietary changes help relieve symptoms.

“Women should be counseled to eat whatever pregnancy-safe food appeals to them and lifestyle changes should be liberally encouraged,” said Dr. Kim Campbell, the guidelines’ principal author and a registered midwife.

The use of medications is generally discouraged during pregnancy, but sometimes it seems like nothing else will cure morning sickness.

In the U.S., the only “Pregnancy Class A” medication for morning sickness is Diglegis, a combination of Vitamin B6 (pyridoxine) and an antihistamine (doxylamine). Another option is the anti-heartburn drug Reglan (metroclopramide) a “Class B” medication for pregnant women.

Dr. Campbell says the last-line treatment when other medication fail should be Zofran (ondansetron), an anti-nausea drug for chemotherapy and surgery patients manufactured by GlaxoSmithKline (GSK).

GSK is facing nearly 400 Zofran birth defect lawsuits. The company paid a $3 billion settlement after being accused of marketing Zofran to pregnant women and paying kickbacks to doctors who prescribed it.

In 2014, a study found that Zofran doubled the risk of having a baby with a “hole in the heart” defect. In 2012, another study found a 2.4-fold increased risk of cleft palate.

Source: The Management of Nausea and Vomiting of Pregnancy

Posted by Elizabeth Bradley

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