Medline ® Abstract for Reference 98
of 'Treatment and outcome of nausea and vomiting of pregnancy'
Experience with oral methylprednisolone in the treatment of refractory hyperemesis gravidarum.
Safari HR, Alsulyman OM, Gherman RB, Goodwin TM
Am J Obstet Gynecol. 1998;178(5):1054.
OBJECTIVE: Our purpose was to describe the effect of oral methylprednisolone on the course of refractory hyperemesis gravidarum.
STUDY DESIGN: Patients with intractable hyperemesis gravidarum were candidates for oral methylprednisolone. Forty-eight milligrams per day was given for 3 days followed by a tapering dose over 2 weeks. If vomiting recurred after 2 weeks of therapy or during tapering, the medication was restarted or extended but not longer than 1 month total.
RESULTS: Seventeen of 18 patients (94%) were free of vomiting and were able to tolerate a regular diet within 3 days. Seven did not have further symptoms during their pregnancies. Nine vomited during or after tapering, but 7 of these responded to extension or reinstitution of therapy. Four of 6 patients on total parenteral nutrition at the start of therapy had a complete response within 3 days.
CONCLUSIONS: A short course of oral methylprednisolone appears to be a reasonable therapeutic alternative for intractable hyperemesis.
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.