The authors of this article review the management of nausea and vomiting in pregnancy, under the following headings:

• Who gets hyperemesis gravidarum?
• What is the underlying pathophysiology of nausea and vomiting in pregnancy?
• How is hyperemesis gravidarum diagnosed?
• What are the treatment options? (this section discusses diet and supplements, Intravenous fluids, vitamin supplements, and thromboprophylaxis, antiemetics, and corticosteroids)
• Clinical model of care in nausea and vomiting in pregnancy

The authors note that nausea and vomiting in pregnancy are common, but they are mostly self limiting and resolve by 16-20 weeks’ gestation.  In a subset of women, symptoms can be severe and hyperemesis gravidarum can ensue. Clinicians must therefore be aware of the need for timely community based treatment if appropriate, and when they should refer to secondary care. 

Recommended antiemetic regimens are discussed, as are the criteria for referral to secondary care, including an algorithm to support clinical decision making.  The authors note that early drug treatment may be necessary to avoid maternal metabolic disarray from uncontrolled nausea and vomiting, and comment that “all healthcare providers who care for pregnant women must be aware of the range of symptoms and be able to assess severity while providing effective treatment in a timely manner.”