This prospective double-blinded randomized controlled trial compared metoclopramide and promethazine in the treatment of hyperemesis gravidarum. Participants in the study were women admitted to the Gynecology ward at a university hospital in Kuala Lumpur, Malaysia who had dehydration and detectable ketonuria, were under 16 weeks gestation, and did not have another known cause of nausea and vomiting. All patients received intravenous hydration. Patients in both treatment groups had similar primary outcomes, including well-being measured on a visual numerical rating scale and frequency of vomiting in the first 24 h. Patients also had similar secondary outcomes, including nausea as measured on a visual numerical rating scale and persistence of ketonuria at 24 h. However, patients in the promethazine arm had significantly greater occurrence of adverse events, including drowsiness (p=0.001), dizziness (p<0.001), and dystonia (p=0.02).
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© 2010 Published by Elsevier Inc.