Comparing the effects of prednisolone and promethazine in the treatment of hyperemesis gravidarum: a double-blind, randomized clinical trial

Nausea and vomiting during pregnancy is one of the most frequent obstetric problems of unknown etiology and there is no definitive treatment for it. The purpose of this study was to compare the effects of prednisolone and promethazine in the treatment of hyperemesis gravidarum.

This double-blind clinical trial study was conducted on 70 pregnant women, with a singleton pregnancy at less than 16 weeks of gestation, with hyperemesis gravidarum. Women were randomly divided into two groups to receive either prednisolone (5mg) or promethazine (25mg) three times daily; they received capsules with similar shapes but different codes. The dose of medication was tapered down after the first week and it was discontinued after two weeks. Finally, women were studied for relapse symptoms during the treatment and two weeks post-treatment.

There was a significant difference in the improvement of symptoms between the two groups during the course of treatment and also two weeks post-treatment (P=0.001). Moreover, there was no significant difference between the two groups in the frequency of nausea and vomiting during the first 4 days, in the 14th day of the treatment and 2 weeks post-treatment (P=0.07).

Results show that both prednisolone and promethazine are effective to control hyperemesis gravidarum.