Successful management of hyperemesis gravidarum using steroid therapy

Hyperemesis gravidarum causes uncontrollable vomiting, severe dehydration and muscle wasting in pregnancy and usually requires weeks or months of intravenous fluid therapy. A consecutive series of 7 women with hyperemesis gravidarum were treated with high-dose steroid therapy. Vomiting stopped within 3 h of the first dose of intravenous hydrocortisone in all patients. Maintainence oral prednisolone therapy in doses up to 45 mg/day permitted discharge from hospital within days, resumption of normal eating, reversal of muscle wasting and regain of lost weight (mean loss from prepregnant weight 10.5 +/- 4.3 kg). Prednisolone in doses of 15 mg/day or more was required for 10.6 +/- 4.7 (range 6-20) weeks. High-dose prednisolone therapy is effective in suppressing symptoms of intractable hyperemesis gravidarum and allowing normal maternal nutrition.