August 2004 · Vol. 16, No. 8Nausea and vomiting of pregnancy:
Q&A with T. Murphy Goodwin
An expert tells why this common condition is undertreated, and what can help, including how to formulate the effective drug formerly marketed as Bendectin.
JANELLE
YATES,
SENIOR ASSOCIATE EDITOR
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KEY POINTS
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About 35% of gravidas have nausea and vomiting severe enough to disrupt their daily routine. As many as 50% of women with severe NVP are not offered antiemetic therapy, studies show.
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At any level of severity, nausea and vomiting cause psychosocial morbidity.
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Multivitamin use at the time of conception reduces the severity of nausea and vomiting.
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When drug therapy is necessary, start with 10 to 25 mg pyridoxine (vitamin B6) 3 or 4 times daily.
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If nausea and vomiting continue, add 12.5 mg doxylamine (by halving the over-the-counter sleep aid Unisom) to each dose of pyridoxine. The pyridoxine-doxylamine combination is the same formulation as the highly effective drug Bendectin, which is no longer available in the US.
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T. Murphy Goodwin, MD, a contributor to the new American College of Obstetricians and Gynecologists practice bulletin on nausea and vomiting of pregnancy (NVP),1 tells why it is important to ask every patient about nausea and vomiting, when to intervene, and what the best treatments are—including a substitute compound for the no-longer-available drug Bendectin.
Dr. Goodwin is professor of obstetrics and gynecology at the Keck School of Medicine, University of Southern California, Los Angeles.
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