DROPERIDOL AND DIPHENHYDRAMINE IN THE MANAGEMENT OF HYPEREMESIS GRAVIDARUM

OBJECTIVE: Hyperemesis gravidarum is a common pregnancy complication r equiring hospitalization. Continuous droperidol infusion and bolus int ravenous diphenhydramine were instituted as treatment. We compared the number and length of hospitalizations for hyperemesis gravidarum, rea dmissions for this diagnosis, and pregnancy outcome in patients receiv ing this treatment protocol with a historic group of patients receivin g other forms of parenteral therapy for hyperemesis gravidarum. STUDY DESIGN: All patients hospitalized with a diagnosis of hyperemesis grav idarum between January 1992 and January 1994 were offered the droperid ol-diphenhydramine protocol. These patients were compared with patient s admitted between January 1990 and January 1999 with a diagnosis of h yperemesis gravidarum but who were not treated with droperidol at any time or with diphenhydramine as primary therapy for the control of sev ere nausea and vomiting. Data regarding the number and length of hospi talizations and readmissions for hyperemesis gravidarum were compared. as were maternal and perinatal outcomes. RESULTS: Patients treated wi th the droperidol-diphenhydramine protocol had significantly shorter h ospitalizations (3.1 +/- 1.9 vs 3.8 +/- 2.4 days, p = 0.028), fewer da ys per pregnancy hospitalized for hyperemesis (3.5 +/- 2.3 days vs 4.8 +/- 4.3 days, p = 0.018), and fewer readmissions with this diagnosis (15.0% vs 31.5%, p = 0.015). There were no significant differences in maternal or perinatal outcomes. CONCLUSION: Droperidol and diphenhydra mine infusion is a beneficial, cost-effective therapy for the treatmen t of hyperemesis gravidarum.