Ondasetron versus dexamethazone for treating patients with intractable hyperemesis gravidarum: a randomized study

ABSTRACT

To evaluate the antiemetic effectiveness of ondasetron and dexamethasone in patients with intactable hyperemesis gravidarum. OB. and Gyn. Department, Sohag University hospital. A prospective randomized study. Sixteen patients with hyperemesis gravidarum resistant to the conventional therapy. There were randomly allocated into two groups; the 1st [8 patients] treated with ondasetron 4 mg/day I.V. as a single injection while the 2nd group was treated with dexamethazone 24 mg/day I.V. on three divided doses. The frequency of vomiting was evaluated for every patient daily every morning. At the end of the study period, the antiemetic efficacy, the duration of hospital stay and the side effects of both drugs were compared. 38% of patients receiving ondasetron [group I] showed stoppage of vomiting after a single injection. After the 2nd injection, all patients were cured of vomiting. The average duration of hospital stay was 3.8 +/- 0.8 days. In group II, only one patient [12.5%] showed improvement of vomiting after the 1st day of treatment. After the 3rd day of treatment, only 12.5% of patients were cured while 50% of patients were resistant to dexamethazone. The average hospital stay was 6.2 +/- 1.3 days. The difference between the two groups regarding the antiemetic efficacy and the duration of hospital stay was statistically significant [P < 0.05]. No side effects for both drugs have been reported. Ondasetron is a highly effective drug for treating women with intactable hyperemesis gravidarum. It is more effective than dexamethazone, associated with less frequent injection, less hospital stay and produces no significant side effects. Ondasetron should be only used as a last resort as an alternative to termination of pregnancy