Randomised, double-blind, placebo-controlled trial of corticosteroids for the treatment of hyperemesis gravidarum

C. Nelson-Piercy, Peter Fayers, M. de Swiet

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Objective To assess the efficacy of corticosteroids in the treatment of severe hyperemesis gravidarum refractory to conventional management.

Design Multicentre, double-blind, randomised, placebo-controlled trial.

Setting Inpatient gynaecology wards in eight collaborating centres.

Population Twenty-five women with severe hyperemesis of which 24 completed the one- week study period.

Methods Twenty-five women were randomised to receive either 40 mg prednisolone daily in two divided oral doses, or equivalent placebo tablets. If, after three days, a woman was still vomiting, medication was changed to the equivalent intravenous alternative (hydrocortisone 100mg twice daily or normal saline injections)

Main outcome measures Frequency of vomiting and the dependence on intravenous fluid replacement therapy after one week of treatment.

Results There was a non-significant trend towards improved nausea and vomiting and reduced dependence on intravenous fluids. However, steroid therapy led to an improved sense of wellbeing (P = 0.021), improved appetite (P = 0.039) and increased weight gain (P = 0.025) compared with placebo. There was no difference in pregnancy outcome between the treatment and placebo groups.

Conclusions This study supports a beneficial role for steroids in severe hyperemesis, but did not validate the hypothesis that they lead to rapid and complete remission of symptoms. The study was not large enough to demonstrate a significant improvement in the primary outcome measures.

Original languageEnglish
Pages (from-to)9-15
Number of pages6
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume188
DOIs
Publication statusPublished - 2001

Keywords

  • WERNICKES ENCEPHALOPATHY
  • PREGNANCY
  • METHYLPREDNISOLONE
  • THERAPY

Cite this

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title = "Randomised, double-blind, placebo-controlled trial of corticosteroids for the treatment of hyperemesis gravidarum",
abstract = "Objective To assess the efficacy of corticosteroids in the treatment of severe hyperemesis gravidarum refractory to conventional management.Design Multicentre, double-blind, randomised, placebo-controlled trial.Setting Inpatient gynaecology wards in eight collaborating centres.Population Twenty-five women with severe hyperemesis of which 24 completed the one- week study period.Methods Twenty-five women were randomised to receive either 40 mg prednisolone daily in two divided oral doses, or equivalent placebo tablets. If, after three days, a woman was still vomiting, medication was changed to the equivalent intravenous alternative (hydrocortisone 100mg twice daily or normal saline injections)Main outcome measures Frequency of vomiting and the dependence on intravenous fluid replacement therapy after one week of treatment.Results There was a non-significant trend towards improved nausea and vomiting and reduced dependence on intravenous fluids. However, steroid therapy led to an improved sense of wellbeing (P = 0.021), improved appetite (P = 0.039) and increased weight gain (P = 0.025) compared with placebo. There was no difference in pregnancy outcome between the treatment and placebo groups.Conclusions This study supports a beneficial role for steroids in severe hyperemesis, but did not validate the hypothesis that they lead to rapid and complete remission of symptoms. The study was not large enough to demonstrate a significant improvement in the primary outcome measures.",
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author = "C. Nelson-Piercy and Peter Fayers and {de Swiet}, M.",
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doi = "10.1016/S0306-5456(00)00017-6",
language = "English",
volume = "188",
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issn = "1470-0328",
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TY - JOUR

T1 - Randomised, double-blind, placebo-controlled trial of corticosteroids for the treatment of hyperemesis gravidarum

AU - Nelson-Piercy, C.

AU - Fayers, Peter

AU - de Swiet, M.

PY - 2001

Y1 - 2001

N2 - Objective To assess the efficacy of corticosteroids in the treatment of severe hyperemesis gravidarum refractory to conventional management.Design Multicentre, double-blind, randomised, placebo-controlled trial.Setting Inpatient gynaecology wards in eight collaborating centres.Population Twenty-five women with severe hyperemesis of which 24 completed the one- week study period.Methods Twenty-five women were randomised to receive either 40 mg prednisolone daily in two divided oral doses, or equivalent placebo tablets. If, after three days, a woman was still vomiting, medication was changed to the equivalent intravenous alternative (hydrocortisone 100mg twice daily or normal saline injections)Main outcome measures Frequency of vomiting and the dependence on intravenous fluid replacement therapy after one week of treatment.Results There was a non-significant trend towards improved nausea and vomiting and reduced dependence on intravenous fluids. However, steroid therapy led to an improved sense of wellbeing (P = 0.021), improved appetite (P = 0.039) and increased weight gain (P = 0.025) compared with placebo. There was no difference in pregnancy outcome between the treatment and placebo groups.Conclusions This study supports a beneficial role for steroids in severe hyperemesis, but did not validate the hypothesis that they lead to rapid and complete remission of symptoms. The study was not large enough to demonstrate a significant improvement in the primary outcome measures.

AB - Objective To assess the efficacy of corticosteroids in the treatment of severe hyperemesis gravidarum refractory to conventional management.Design Multicentre, double-blind, randomised, placebo-controlled trial.Setting Inpatient gynaecology wards in eight collaborating centres.Population Twenty-five women with severe hyperemesis of which 24 completed the one- week study period.Methods Twenty-five women were randomised to receive either 40 mg prednisolone daily in two divided oral doses, or equivalent placebo tablets. If, after three days, a woman was still vomiting, medication was changed to the equivalent intravenous alternative (hydrocortisone 100mg twice daily or normal saline injections)Main outcome measures Frequency of vomiting and the dependence on intravenous fluid replacement therapy after one week of treatment.Results There was a non-significant trend towards improved nausea and vomiting and reduced dependence on intravenous fluids. However, steroid therapy led to an improved sense of wellbeing (P = 0.021), improved appetite (P = 0.039) and increased weight gain (P = 0.025) compared with placebo. There was no difference in pregnancy outcome between the treatment and placebo groups.Conclusions This study supports a beneficial role for steroids in severe hyperemesis, but did not validate the hypothesis that they lead to rapid and complete remission of symptoms. The study was not large enough to demonstrate a significant improvement in the primary outcome measures.

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KW - METHYLPREDNISOLONE

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