Context
Nausea and Vomiting of Pregnancy (NVP) is a very common condition which affects 90% of pregnant women.1 It has a wide range of severity with Hyperemesis Gravidarum (HG) at the most extreme end.
Presentations to the Emergency Department for NVP have been increasing year on year, with around 2.1% of all pregnant patients requiring a hospital admission, resulting in an estimated annual cost to the NHS of £62 million.2-3
NVP and HG can cause significant morbidity for both the mother and the fetus.
From a maternal perspective, it can severely impact quality of life during pregnancy, making day-to-day activities impossible, and resulting in increased rates of post-natal depression, anxiety and PTSD postpartum.4 It can be most significant in those with pre-existing conditions such as diabetes and epilepsy, where an inability to take oral medication can cause complications.
There is also an association between NVP and low birthweight, being small for gestational age, increased risk of resuscitation at birth or NICU admission.5
The most recent iteration of the RCOG Green Top Guideline on the topic of Nausea and Vomiting of pregnancy was updated in February 2024 with some key changes to both assessment and management of this condition.2 The full guideline can be accessed here.
Learning Bite
Nausea and Vomiting of Pregnancy is a common condition affecting up to 90% of pregnancies, with associated impacts on quality of life and morbidity for both the mother and the fetus.