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. 2022 Jun 27;19(2):162-169.
doi: 10.4274/tjod.galenos.2022.14367.

Ondansetron versus metoclopramide for managing hyperemesis gravidarum: A systematic review and meta-analysis of randomized controlled trials

Ebraheem Albazee  1 , Lina Almahmoud  1 , Firas Al-Rshoud  2 , Dima Sallam  1 , Wardah Albzea  3 , Rawan Alenezi  4 , Saeed Baradwan  5 , Ahmed Abu-Zaid  6
Affiliations

Ondansetron versus metoclopramide for managing hyperemesis gravidarum: A systematic review and meta-analysis of randomized controlled trials

Ebraheem Albazee et al. Turk J Obstet Gynecol. .

Abstract

This investigation examined the efficacy of ondansetron (intervention) versus metoclopramide (control) in managing parturient females with hyperemesis gravidarum (HG), by pooling data from randomized controlled trials (RCTs) using a meta-analysis approach. From inception until January 2022, five information sources were screened: Cochrane Central Register of Controlled Trials, Google Scholar, Scopus, PubMed and Web of Science. Quality assessment was done through the Cochrane Risk of Bias (version 2) assessment tool. The mean difference (MD) with 95% confidence interval (CI) was used to summarize the continuous data in a fixed- or random-effects model, depending on the extent of between-study heterogeneity. Five RCTs were included, comprising a total of 695 patients (355 and 340 females were assigned to ondansetron and metoclopramide, respectively). Four RCTs had an overall "low" risk of bias, whereas one RCT had an overall "some concerns" due to lack of sufficient information about randomization. There was no significant difference between both groups regarding the pregnancy-unique quantification of emesis and nausea score [MD=0.23, 95% CI (-0.42, 0.88), p=0.49], length of hospital stay [MD=-0.17 days, 95% CI (-0.35, 0.02), p=0.08], the number of doses of drug received [MD=0.45, 95% CI (-0.08, 0.98), p=0.10], and duration of intravenous fluids [MD=-1.73 hours, 95% CI (-5.79, 2.33), p=0.40]. Among parturient females with HG, there was no substantial difference in efficacy between both agents. Nevertheless, ondansetron is favored over metoclopramide in view of its trending therapeutic efficacy and better safety profile.

Keywords: Ondansetron; hyperemesis gravidarum; metoclopramide; nausea; vomiting.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart for literature search
Figure 2
Figure 2
The baseline characteristics of the included studies
Figure 3
Figure 3
Meta-analysis of the pregnancy-unique quantification of emesis and nausea (PUQE)
Figure 4
Figure 4
Meta-analysis of the length of hospital stay
Figure 5
Figure 5
Meta-analysis of the number of doses of drug received
Figure 6
Figure 6
Meta-analysis of the duration of intravenous fluids
See this image and copyright information in PMC

References

    1. Jarvis S, Nelson-Piercy C. Management of nausea and vomiting in pregnancy. BMJ. 2011;342:d3606. - PubMed
    1. Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011;40:309–34, vii. - PMC - PubMed
    1. London V, Grube S, Sherer DM, Abulafia O. Hyperemesis Gravidarum: A Review of Recent Literature. Pharmacology. 2017;100:161–71. - PubMed
    1. Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T. The Management of Nausea and Vomiting of Pregnancy: Synthesis of National Guidelines. Obstet Gynecol Surv. 2019;74:161–9. - PubMed
    1. Abas MN, Tan PC, Azmi N, Omar SZ. Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet Gynecol. 2014;123:1272–9. - PubMed

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