Ondansetron is safe in pregnancy

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Ondansetron = teratogenic tool of the devil?
Many obstetricians have stopped using ondansetron in hyperemesis for fear of causing birth defects.  This large study found women are actually more likely to have a baby with a VSD or cleft palate if they don't take ondansetron (though there is no statistically significant increase).  And women, "who took ondansetron reported less miscarriages and terminations, and higher live birth rates."

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Don't be afraid to give ondansetron to women with hyperemesis gravidarum.  They will feel better, not have increased risk of birth defects, and have better pregnancy outcomes.  Listen to this free deep dive on this topic on UrgentCare:Rap.

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Abstract

Ondansetron in pregnancy and risk of adverse fetal outcomes in the United States.
Reprod Toxicol. 2016 Jul;62:87-91. doi: 10.1016/j.reprotox.2016.04.027. Epub 2016 May 2.

Fejzo MS1, MacGibbon KW2, Mullin PM3.

Author information:

1University of California, Los Angeles, Department of Medicine, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Department of Maternal-Fetal Medicine, Los Angeles, CA, USA. Electronic address: mfejzo@mednet.ucla.edu.

2Hyperemesis Education and Research Foundation, Damascus, OR, USA.

3Keck School of Medicine, University of Southern California, Department of Maternal-Fetal Medicine, Los Angeles, CA, USA.

Abstract

This is an analysis of fetal outcome in pregnancies exposed to ondansetron to treat Hyperemesis Gravidarum (HG). In this retrospective cohort study, U.S. data on outcome were collected on 1070 pregnancies exposed to ondansetron and compared to outcomes in two control groups: 771 pregnancies in women with a history of HG with no ondansetron exposure and 1555 pregnancies with neither a history of HG nor ondansetron exposure. Ventricular septal defects were reported in 2/952 of infants in the HG/Ondansetron-exposure group and 4/1286 in the No HG/No Ondansetron-exposure group. Cleft palate was reported in 1/952 live births in the HG/Ondansetron and 2/1286 in the No HG/No Ondansetron-exposure groups. Women with a history of HG who took ondansetron reported less miscarriages and terminations, and higher live birth rates. The overall results do not support evidence of teratogenicity of ondansetron.

Copyright © 2016 Elsevier Inc. All rights reserved.

PMID: 27151373 [PubMed - in process]