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Comparison 1 All antiemetic medication compared with placebo, Outcome 1 Effect on nausea.
Figures and Tables -
Analysis 1.1

Comparison 1 All antiemetic medication compared with placebo, Outcome 1 Effect on nausea.

Comparison 1 All antiemetic medication compared with placebo, Outcome 2 Effect on drowsiness or sleepiness.
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Analysis 1.2

Comparison 1 All antiemetic medication compared with placebo, Outcome 2 Effect on drowsiness or sleepiness.

Comparison 1 All antiemetic medication compared with placebo, Outcome 3 Effect on miscarriage or neonatal loss.
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Analysis 1.3

Comparison 1 All antiemetic medication compared with placebo, Outcome 3 Effect on miscarriage or neonatal loss.

Comparison 1 All antiemetic medication compared with placebo, Outcome 4 Effect on fetal abnormality.
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Analysis 1.4

Comparison 1 All antiemetic medication compared with placebo, Outcome 4 Effect on fetal abnormality.

Comparison 2 Bendectin (Debendox) compared with placebo, Outcome 1 Effect on nausea.
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Analysis 2.1

Comparison 2 Bendectin (Debendox) compared with placebo, Outcome 1 Effect on nausea.

Comparison 3 Antihistamines compared with placebo, Outcome 1 Effect on nausea.
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Analysis 3.1

Comparison 3 Antihistamines compared with placebo, Outcome 1 Effect on nausea.

Comparison 4 Phenothiazines compared with placebo, Outcome 1 Effect on nausea.
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Analysis 4.1

Comparison 4 Phenothiazines compared with placebo, Outcome 1 Effect on nausea.

Comparison 5 Vitamin B6 compared with placebo, Outcome 1 Effect on vomiting.
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Analysis 5.1

Comparison 5 Vitamin B6 compared with placebo, Outcome 1 Effect on vomiting.

Comparison 5 Vitamin B6 compared with placebo, Outcome 2 Improvement in nausea score.
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Analysis 5.2

Comparison 5 Vitamin B6 compared with placebo, Outcome 2 Improvement in nausea score.

Comparison 6 Ginger compared with placebo, Outcome 1 Effect on vomiting.
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Analysis 6.1

Comparison 6 Ginger compared with placebo, Outcome 1 Effect on vomiting.

Comparison 6 Ginger compared with placebo, Outcome 2 Effect on nausea.
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Analysis 6.2

Comparison 6 Ginger compared with placebo, Outcome 2 Effect on nausea.

Comparison 6 Ginger compared with placebo, Outcome 3 Effect on miscarriage.
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Analysis 6.3

Comparison 6 Ginger compared with placebo, Outcome 3 Effect on miscarriage.

Comparison 7 Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure, Outcome 1 Effect on morning sickness.
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Analysis 7.1

Comparison 7 Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure, Outcome 1 Effect on morning sickness.

Comparison 7 Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure, Outcome 2 Effect on vomiting score.
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Analysis 7.2

Comparison 7 Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure, Outcome 2 Effect on vomiting score.

Comparison 7 Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure, Outcome 3 Effect on nausea score.
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Analysis 7.3

Comparison 7 Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure, Outcome 3 Effect on nausea score.

Comparison 8 Acupuncture or acupressure compared with no treatment, Outcome 1 Effect on morning sickness.
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Analysis 8.1

Comparison 8 Acupuncture or acupressure compared with no treatment, Outcome 1 Effect on morning sickness.

Comparison 8 Acupuncture or acupressure compared with no treatment, Outcome 2 Effect on vomiting score.
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Analysis 8.2

Comparison 8 Acupuncture or acupressure compared with no treatment, Outcome 2 Effect on vomiting score.

Comparison 8 Acupuncture or acupressure compared with no treatment, Outcome 3 Effect on nausea score.
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Analysis 8.3

Comparison 8 Acupuncture or acupressure compared with no treatment, Outcome 3 Effect on nausea score.

Comparison 9 Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum, Outcome 1 Effect on persistent vomiting within 4 days of treatment.
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Analysis 9.1

Comparison 9 Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum, Outcome 1 Effect on persistent vomiting within 4 days of treatment.

Comparison 9 Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum, Outcome 2 Effect on subsequent readmission to hospital.
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Analysis 9.2

Comparison 9 Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum, Outcome 2 Effect on subsequent readmission to hospital.

Comparison 9 Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum, Outcome 3 Effect on spontaneous abortion.
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Analysis 9.3

Comparison 9 Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum, Outcome 3 Effect on spontaneous abortion.

Comparison 10 Ginger versus placebo for hyperemesis gravidarum, Outcome 1 Improvement in hyperemesis symptom score.
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Analysis 10.1

Comparison 10 Ginger versus placebo for hyperemesis gravidarum, Outcome 1 Improvement in hyperemesis symptom score.

Comparison 11 Diazepam versus placebo for hyperemesis gravidarum, Outcome 1 Effect on persistence of vomiting.
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Analysis 11.1

Comparison 11 Diazepam versus placebo for hyperemesis gravidarum, Outcome 1 Effect on persistence of vomiting.

Comparison 11 Diazepam versus placebo for hyperemesis gravidarum, Outcome 2 Effect on readmission with recurrent symptoms.
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Analysis 11.2

Comparison 11 Diazepam versus placebo for hyperemesis gravidarum, Outcome 2 Effect on readmission with recurrent symptoms.

Comparison 11 Diazepam versus placebo for hyperemesis gravidarum, Outcome 3 Effect on length of stay in hospital.
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Analysis 11.3

Comparison 11 Diazepam versus placebo for hyperemesis gravidarum, Outcome 3 Effect on length of stay in hospital.

Comparison 12 Methylprednisolone versus promethazine for hyperemesis gravidarum, Outcome 1 Effect on persistence of vomiting.
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Analysis 12.1

Comparison 12 Methylprednisolone versus promethazine for hyperemesis gravidarum, Outcome 1 Effect on persistence of vomiting.

Comparison 12 Methylprednisolone versus promethazine for hyperemesis gravidarum, Outcome 2 Effect on subsequent readmission to hospital.
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Analysis 12.2

Comparison 12 Methylprednisolone versus promethazine for hyperemesis gravidarum, Outcome 2 Effect on subsequent readmission to hospital.

Comparison 13 Ondansetron versus promethazine for hyperemesis gravidarum, Outcome 1 Effect on persistence of vomiting.
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Analysis 13.1

Comparison 13 Ondansetron versus promethazine for hyperemesis gravidarum, Outcome 1 Effect on persistence of vomiting.

Comparison 14 Acupuncture or acupressure for hyperemesis gravidarum, Outcome 1 Effect on persistent vomiting.
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Analysis 14.1

Comparison 14 Acupuncture or acupressure for hyperemesis gravidarum, Outcome 1 Effect on persistent vomiting.

Comparison 1. All antiemetic medication compared with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on nausea Show forest plot

12

1505

Odds Ratio (M‐H, Random, 95% CI)

0.16 [0.08, 0.33]

2 Effect on drowsiness or sleepiness Show forest plot

4

343

Odds Ratio (M‐H, Random, 95% CI)

2.24 [1.05, 4.75]

3 Effect on miscarriage or neonatal loss Show forest plot

1

161

Odds Ratio (M‐H, Random, 95% CI)

0.96 [0.32, 2.87]

4 Effect on fetal abnormality Show forest plot

1

161

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.03, 3.07]

Figures and Tables -
Comparison 1. All antiemetic medication compared with placebo
Comparison 2. Bendectin (Debendox) compared with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on nausea Show forest plot

3

240

Odds Ratio (M‐H, Random, 95% CI)

0.23 [0.07, 0.70]

Figures and Tables -
Comparison 2. Bendectin (Debendox) compared with placebo
Comparison 3. Antihistamines compared with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on nausea Show forest plot

6

571

Odds Ratio (M‐H, Random, 95% CI)

0.20 [0.06, 0.63]

Figures and Tables -
Comparison 3. Antihistamines compared with placebo
Comparison 4. Phenothiazines compared with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on nausea Show forest plot

2

300

Odds Ratio (M‐H, Random, 95% CI)

0.09 [0.00, 1.88]

Figures and Tables -
Comparison 4. Phenothiazines compared with placebo
Comparison 5. Vitamin B6 compared with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on vomiting Show forest plot

2

392

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.18, 2.26]

2 Improvement in nausea score Show forest plot

2

395

Mean Difference (IV, Random, 95% CI)

‐0.99 [‐1.47, ‐0.51]

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Comparison 5. Vitamin B6 compared with placebo
Comparison 6. Ginger compared with placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on vomiting Show forest plot

1

67

Odds Ratio (M‐H, Random, 95% CI)

0.31 [0.12, 0.85]

2 Effect on nausea Show forest plot

1

67

Odds Ratio (M‐H, Random, 95% CI)

0.06 [0.02, 0.21]

3 Effect on miscarriage Show forest plot

1

67

Odds Ratio (M‐H, Random, 95% CI)

0.34 [0.03, 3.49]

Figures and Tables -
Comparison 6. Ginger compared with placebo
Comparison 7. Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on morning sickness Show forest plot

2

285

Odds Ratio (M‐H, Random, 95% CI)

0.35 [0.12, 1.06]

2 Effect on vomiting score Show forest plot

2

332

Mean Difference (IV, Random, 95% CI)

‐0.31 [‐0.76, 0.14]

3 Effect on nausea score Show forest plot

2

332

Mean Difference (IV, Random, 95% CI)

‐0.57 [‐1.41, 0.26]

Figures and Tables -
Comparison 7. Acupuncture or acupressure, compared with sham or dummy acupuncture or acupressure
Comparison 8. Acupuncture or acupressure compared with no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on morning sickness Show forest plot

1

238

Odds Ratio (M‐H, Random, 95% CI)

0.25 [0.14, 0.43]

2 Effect on vomiting score Show forest plot

1

265

Mean Difference (IV, Random, 95% CI)

‐0.30 [‐0.79, 0.19]

3 Effect on nausea score Show forest plot

1

265

Mean Difference (IV, Random, 95% CI)

‐0.70 [‐1.45, 0.05]

Figures and Tables -
Comparison 8. Acupuncture or acupressure compared with no treatment
Comparison 9. Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on persistent vomiting within 4 days of treatment Show forest plot

2

56

Odds Ratio (M‐H, Random, 95% CI)

1.96 [0.39, 9.93]

2 Effect on subsequent readmission to hospital Show forest plot

2

56

Odds Ratio (M‐H, Random, 95% CI)

0.53 [0.14, 1.95]

3 Effect on spontaneous abortion Show forest plot

1

32

Odds Ratio (M‐H, Random, 95% CI)

1.0 [0.06, 17.51]

Figures and Tables -
Comparison 9. Adrenocorticotropic hormone or steroids versus placebo for hyperemesis gravidarum
Comparison 10. Ginger versus placebo for hyperemesis gravidarum

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Improvement in hyperemesis symptom score Show forest plot

1

27

Mean Difference (IV, Random, 95% CI)

‐3.15 [‐7.22, 0.92]

Figures and Tables -
Comparison 10. Ginger versus placebo for hyperemesis gravidarum
Comparison 11. Diazepam versus placebo for hyperemesis gravidarum

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on persistence of vomiting Show forest plot

1

50

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.10, 4.19]

2 Effect on readmission with recurrent symptoms Show forest plot

1

50

Odds Ratio (M‐H, Random, 95% CI)

0.13 [0.01, 1.19]

3 Effect on length of stay in hospital Show forest plot

1

50

Mean Difference (IV, Random, 95% CI)

‐1.10 [‐2.07, ‐0.13]

Figures and Tables -
Comparison 11. Diazepam versus placebo for hyperemesis gravidarum
Comparison 12. Methylprednisolone versus promethazine for hyperemesis gravidarum

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on persistence of vomiting Show forest plot

1

40

Odds Ratio (M‐H, Random, 95% CI)

1.59 [0.24, 10.70]

2 Effect on subsequent readmission to hospital Show forest plot

1

35

Odds Ratio (M‐H, Random, 95% CI)

0.07 [0.00, 1.38]

Figures and Tables -
Comparison 12. Methylprednisolone versus promethazine for hyperemesis gravidarum
Comparison 13. Ondansetron versus promethazine for hyperemesis gravidarum

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on persistence of vomiting Show forest plot

1

30

Odds Ratio (M‐H, Random, 95% CI)

0.29 [0.03, 3.12]

Figures and Tables -
Comparison 13. Ondansetron versus promethazine for hyperemesis gravidarum
Comparison 14. Acupuncture or acupressure for hyperemesis gravidarum

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Effect on persistent vomiting Show forest plot

1

33

Odds Ratio (M‐H, Random, 95% CI)

0.23 [0.05, 1.03]

Figures and Tables -
Comparison 14. Acupuncture or acupressure for hyperemesis gravidarum