Intramuscular Acth or Placebo in the Treatment of Hyperemesis Gravidarum

Abstract

Thirty-two women with hyperemesis gravidarum were treated with intramuscular ACTH (0.5 mg) or placebo for 4 days in a randomized double-blind trial. The two treatments were equally effective in relieving hyperemesis, although the function of the adrenal cortex was stimulated only during the ACTH therapy. The administration of ACTH thus appears useless for the treatment of severe vomiting in early pregnancy.

Prescribing in maternity care in Russia: The legacy of Soviet medicine

“…Antihistamines are the drugs of choice for nausea and vomiting during pregnancy when simpler medications did not work but were only prescribed by 26 out of 52 of the respondents. In contrast, some prescribed treatments that are harmful or ineffective; three obstetricians use adrenocorticotropin to stop vomiting in early pregnancy despite longstanding evidence that it is ineffective [8,9] and two reported prescribing diethylstilbestrol (which is still available for treatment of breast and prostate cancer) to prevent miscarriage, although it has been known that it is carcinogenic since the late 1960s [10]. All but three respondents prescribed some sort of physical therapy (light, magnetic, electric) during pregnancy.…”

Randomised, double‐blind, placebo‐controlled trial of corticosteroids for the treatment of hyperemesis gravidarum

“…There was no difference in the numbers of women in each group who stopped vomiting within two days, but no patients in the steroid group compared with 5 in the promethazine group required readmission within two weeks of discharge 12 . However, steroids have failed in at least one patient 13 , and intramuscular adrenocorticotrophic hormone (ACTH) has been shown to be no more effective than placebo in the treatment of hyperemesis 15 . This randomised placebo‐controlled study was designed to answer the clinical question “Do steroids improve the symptoms of severe hyperemesis?”.…”

Evaluation of Treatment of Hyperemesis gravidarum Using Parenteral Fluid with or without Diazepam

“…Ylikorkala et al [15] found no benefit of intramuscular ACTH with respect to placebo. Sullivan et al [16] found no benefit of ondansetron compared with promethazine.…”