Magee Laura A, Mazzotta Paolo, Koren Gideon
Department of Specialized Women's Health, BC Women's Hospital and Health Centre, Vancouver, Canada.
Am J Obstet Gynecol. 2002 May;186(5 Suppl Understanding):S256-61. doi: 10.1067/mob.2002.122596.
Our goal was to review the safety and effectiveness of available antiemetics for treatment of nausea and vomiting of pregnancy.
We performed a quantitative and qualitative overview of observational controlled studies for drug safety in pregnancy and randomized controlled trials for drug effectiveness for nausea and vomiting in pregnancy.
All of the following are safe and effective for treatment of varying degrees of nausea and vomiting in pregnancy: Bendectin/Diclectin (doxylamine, pyridoxine, dicyclomine), antihistamine (H(1)) blockers, and phenothiazines; however, the magnitude of effect, particularly for phenothiazines, is in question and may differ among individual agents. Pyridoxine and vitamin B(12)are safe and may be effective. Metoclopramide, droperidol, and ondansetron may be effective, but safety data are insufficient to recommend them as first-line agents. Corticosteroids may not be as beneficial as first thought, and there may be a small teratogenic risk. The relative effectiveness of various agents is largely unknown.
Many medications, particularly H(1)-antagonists and phenothiazines, are safe and effective for treatment of varying degrees of NVP.
我们的目标是回顾现有止吐药治疗妊娠恶心和呕吐的安全性和有效性。
我们对妊娠药物安全性的观察性对照研究以及妊娠恶心和呕吐药物有效性的随机对照试验进行了定量和定性综述。
以下所有药物在治疗妊娠不同程度的恶心和呕吐方面都是安全有效的：敏克静/迪克莱汀（多西拉敏、吡哆醇、双环胺）、组胺（H₁）受体阻滞剂和吩噻嗪类药物；然而，特别是吩噻嗪类药物的疗效程度存在疑问，且不同药物之间可能存在差异。吡哆醇和维生素B₁₂是安全的，可能有效。甲氧氯普胺、氟哌利多和昂丹司琼可能有效，但安全性数据不足以推荐它们作为一线药物。皮质类固醇可能不像最初认为的那样有益，且可能存在小的致畸风险。各种药物的相对有效性很大程度上未知。
许多药物，特别是H₁拮抗剂和吩噻嗪类药物，在治疗不同程度的妊娠剧吐方面是安全有效的。
