Comparison of prednisolone and pyridoxine in hyperemesis gravidarum

Background: despite high prevalence rate of nausea vomiting and mead for treatment in severe
cases which leads to electrolyte imbalances and weight loss, due to lack of knowledge about its
cause, an elear-cut treatment for it, is still unavailable. In this study we compared the effect of
prednisolone to that of pyridoxine on the treatment of severe cases of vomiting during the first half
of pregnancy.
Methods and Materials: In a double blind clinical trial study (2002-2003) 120 women with a
normal intra uterine pregnancy and less than 22 weeks of gestational age with hyper emesis
gravidarum were admitted to Zahedan Qhods hospital for appropriate treatment. Patients
randomly divided in two groups of 60; patients, received prednisolone 5mg /TDS (case group) and
the other 60 patients, received pyridoxine / 20mg/ TDS (control group). 3 days later, serum
electrolytes, severity of vomiting, beginning of diet, and response to treatment were studied. All
patients were followed every week, up to 22 weeks of gestational age.
Results: There was no significant difference between the two groups with respect to maternal
age, gestational age, and gravidity, and weight loss, number of previous admissions recent
pregnancy. There was significant difference between the two groups in electrolyte disorders, start
of feeding after 1-2 days from initiated treatment, recurrent admission 2 weeks after discharge and
response to treatment (P≤ 0.001).90% of the patients in prednisolone group and 61.7% of
pyridoxine group responded positively to the treatment. 3 days after the commencement of the
treatment, 18 people in prednisolone group and 5 in pyridoxine still had electrolyte imbalances.
The proportion of vomiting and hypocalemi modification in prednisolone consumer were,
respectively consumer 4.5 and 4.7 as much as pyriodoxine and the likeliyhood of the relapse of
vomiting in pyridoxine consumer was 3.3 as much as prednisolone.
Conclusions: A short course of a little prednisolone therapy was more effective than pyridoxine
in treatment of hyper emesis gravidarum.