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The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum (Green-top Guideline No.69)

Summary: For this guideline, nausea and vomiting of pregnancy (NVP) is defined as the symptom of nausea and/or vomiting during early pregnancy where there are no other causes, and hyperemesis gravidarum (HG) is the severe form of NVP.

There is variation in the management of women who have NVP or HG with an occasional lack of understanding of its severity and options for treatment and support. The aim of this guideline is to provide evidence-based or best clinical practice information regarding the diagnosis and subsequent management of NVP and HG across community, ambulatory daycare and inpatient settings. It gives advice for multidisciplinary professionals involved in the care of women with these conditions, including how to counsel and support women before, during and after their pregnancies.

COVID disclaimer: This guideline was developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history: This is the first edition of this guideline; the second edition of this guideline is currently in development.

Developer declaration of interests:

Dr M Shehmar: Dr Shehmar is a Trustee for the charity Pregnancy Sickness Support and has given lectures at their meetings.

Dr MA Maclean: Dr Maclean is an advisor to the Miscarriage Association, and has advised and spoken at meetings for the charity Pregnancy Sickness Support.

Professor C Nelson-Piercy: Professor Piercy has received consultancy fees or honoraria and payment for lectures from Warner Chilcott, as well as payment for lectures from Sanofi Aventis. She is an advisor to UCB and Alliance, and receives royalties for the Handbook of Obstetric Medicine, published by CRC Press, Taylor and Francis Group, and for several other publications. Professor Nelson-Piercy is a Trustee of Action on Pre-Eclampsia (APEC), and Joint Editor-in-Chief of the journal Obstetric Medicine, The Medicine of Pregnancy.

Dr R Gadsby: Dr Gadsby has received consultancy fees from Duchesnay and ClearBlue, Swiss Precision Diagnostics GmbH (SPD). He is Vice Chair and Founding Trustee of the charity Pregnancy Sickness Support. 

Dr M O'Hara: Dr O’Hara has received consultancy fees from Alliance. She is a Trustee and volunteer for the charity Pregnancy Sickness Support, and runs her own not-for-profit website

This page was last reviewed 22 June 2016.