Efficacy of Centrally Acting Neuromodulators During Management Hyperemesis Gravidarium: Hospital Based Study

Background: Hyperemesis gravidarum (HG), chemotherapy-induced nausea and vomiting, and postoperative nausea and vomiting were among the disorders alleviated by gabapentin's anti-nausea and anti-emetic properties.Aim: To investigate the comparative impact of gabapentin versus standard treatment protocols for HG.Methods: This randomized controlled open-label trial involved 160 pregnant women aged over 18 with HG. Participants were assigned to two equal groups: Group A, receiving 300mg of gabapentin, and Group B, receiving 7.5mg of metoclopramide.Results: On days 2 and 3 after initial therapy, group A showed substantially lower Pregnancy-Unique Quantification of Emesis and Nausea (PQUE) scores than in group B (P <0.05). Eating scores over the first week were similar between the two groups. Urine acetone levels on day 7 were significantly different between groups (P= 0.042). Group A had considerably lower urine output on admission and days 1, 5, 6, and 7 (P <0.05), as well as lower fluid input on day 4 (P= 0.05). Fluid loss was higher in group A on admission and days 2 and 3 (P <0.05).Conclusion: Gabapentin is a good alternative to metoclopramide in management of HG cases after initial standard replacement therapy for three days especially in lowering acetone in urine on day seven and decreasing PQUE score.