[THE APPROACH TO NAUSEA AND VOMITING IN PREGNANCY]

Nausea and vomiting of pregnancy (NVP) is the most prevalent medical condition during gestation. Approximately 85% of pregnant women suffer from some degree of this condition, while hyperemesis gravidarum (HG), the most severe form, affects up to 2% of women. Although being the leading cause for hospitalization during pregnancy, NVP has received little attention from the medical community. NVP negatively affects women's quality of life, household activity and work productivity. In Canada, the financial cost of NVP, ranges from $132 to $653 per woman/week. In extreme cases, severe NVP results in therapeutic abortions. On the other hand, NVP has been shown to have a protective effect against spontaneous abortions and congenital malformations. Lately, there has been an interest in the hypothesis that NVP is a mechanism protecting the fetus from phytochemicals. Early treatment can prevent future complications and deterioration of the symptoms. Various studies have demonstrated the effectiveness and safety of antiemetic therapy in pregnancy. However, fear of teratogenicity and lack of clinical guidelines lead to trial and error NVP management. We present an updated algorithm for the management of NVP.