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Ondansetron use during pregnancy: a case series
E Ferreira1, M Gillet, J Lelièvre
1Pharmacy Department, CHU Sainte Justine, Faculty of Pharmacy, Université de Montréal, Montréal, Quebec, Canada. ema.ferreira@umontreal.ca
Summary
Ondansetron is a second-line treatment for hyperemesis gravidarum (HG) in pregnant women. This case series found no evidence of teratogenicity, but more data is needed for definitive conclusions.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Neonatology
Background:
- Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy.
- Standard HG treatments may not be effective for all patients.
- Ondansetron is a 5-HT3 receptor antagonist used for nausea and vomiting.
Purpose of the Study:
- To describe the outcomes of pregnancies treated with ondansetron for hyperemesis gravidarum.
- To evaluate the safety and efficacy of ondansetron as a second-line agent for HG management.
- To report on pregnancy and neonatal outcomes in a case series.
Main Methods:
- Descriptive retrospective case series of 14 pregnant women treated with ondansetron for HG.
- Data collected from January 2002 to October 2011 at CHU Sainte-Justine.
- Analysis included 16 pregnancies and 17 newborns due to multiple gestations and separate analyses of pregnancies.
Main Results:
- Ondansetron was initiated around 11.8 weeks' gestation, with seven cases during organogenesis.
- 16 live births occurred, including twins. One minor birth defect (septal defects) was reported after second-trimester exposure.
- Other outcomes included intrauterine growth retardation (IUGR), transient tachypnea, hydrocele, and extrarenal pelvis. Two premature births were noted.
Conclusions:
- No teratogenicity was observed in this case series.
- Ondansetron may be a viable option for HG management when standard treatments fail.
- Further research and larger studies are needed to confirm the safety and efficacy of ondansetron during pregnancy.
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