EXPERIENCE WITH ORAL METHYLPREDNISOLONE IN THE TREATMENT OF REFRACTORY HYPEREMESIS GRAVIDARUM

OBJECTIVE: Our purpose was to describe the effect of oral methylpredni solone on the course of refractory hyperemesis gravidarum. STUDY DESIG N: Patients with intractable hyperemesis gravidarum were candidates fo r oral methylprednisolone. Forty-eight milligrams per day was given fo r 3 days followed by a tapering dose over 2 weeks. If vomiting recurre d after 2 weeks of therapy or during tapering, the medication was rest arted or extended but not longer than 1 month total. RESULTS: Seventee n of 18 patients (94%) were free of vomiting and were able to tolerate a regular diet within 3 days; Seven did not have further symptoms dur ing their pregnancies. Nine vomited during or after tapering, but 7 of these responded to extension or reinstitution of therapy. Four of 6 p atients on total parenteral nutrition at the start of therapy had a co mplete response within 3 days. CONCLUSIONS: A short course of oral met hylprednisolone appears to be a reasonable therapeutic alternative for intractable hyperemesis.