Seubert, David E. MBA, MD; Perry, Sandy; Hoffman, Despina E.; Markenson, Glenn R. MD; Bsat, Fadi A. MD Author Information

OBJECTIVE: This study compares pyridoxine–metoclopramide combination therapy to prochlorperazine and promethazine monotherapies in the outpatient treatment of nausea and vomiting in pregnancy. STUDY DESIGN: In total, 174 first trimester, singleton pregnancies were evaluated for nausea and vomiting. Patients were prospectively randomized into three treatment groups: pyridoxine–metoclopramide, prochlorperazine, or promethazine. Prior to, and on the third day, patients recorded their subjective responses to the given treatment and their number of emesis episodes. The three treatment groups were compared for therapy response. RESULTS: There were no differences in the number of emesis episodes prior to treatment. Both subjective and objective responses to treatment differed among the three groups when comparing the combination therapy to the monotherapies (p<0.05). CONCLUSION: Combination therapy with pyridoxine and metoclopramide appears to be superior to either monotherapy in the treatment of nausea and vomiting in pregnancy.

OBJECTIVE: To determine patterns of immune thrombocytopenia purpura (ITP) progression during pregnancy which may impact the course of clinical care.STUDY DESIGN: Retrospective time course study of all pregnant patients with ITP delivering at UMC-Utrecht from 1980-2000.We applied a 9-point scaled scoring system assessing severity of hemorrhagic diathesis, platelet count and treatment.We evaluated and cmnpared disease severity at six critical time periods: pre-pregnancy, first trimester, third trimester, one year postpartum and the subsequent pregnancy.Wilcoxon matched pairs signed ranks test was used for analysis.RESULTS: There were 21 patients for whom complete data was available.ITP did not improve during pregnancy from pre-pregnancy.However, independent analysis for the first and third trimesters showed a significant improvement in scoring from pre-pregnancy (P< .01 and P< .05,respectively).