Imperial College London
Alternate

Professor Tom Bourne

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Chair in Gynaecology
 
 
 
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Contact

 

+44 (0)20 3313 5131t.bourne Website

 
 
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Location

 

Early pregnancy and acute gynaecologyInstitute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Mitchell-Jones:2017:10.1136/bmjopen-2017-017566,
author = {Mitchell-Jones, N and Farren, J and Tobias, A and Bourne, T and Bottomley, C},
doi = {10.1136/bmjopen-2017-017566},
journal = {BMJ Open},
title = {Ambulatory versus inpatient management of severe nausea and vomiting of pregnancy: a randomized control trial with patient preference arm},
url = {http://dx.doi.org/10.1136/bmjopen-2017-017566},
volume = {7},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective To determine whether ambulatory (outpatient (OP)) treatment of severe nausea and vomiting of pregnancy (NVP) is as effective as inpatient (IP) care.Design Non-blinded randomised control trial (RCT) with patient preference arm.Setting Two multicentre teaching hospitals in London.Participants Women less than 20 weeks’ pregnant with severe NVP and associated ketonuria (>1+).Methods Women who agreed to the RCT were randomised via web-based application to either ambulatory or IP treatment. Women who declined randomisation underwent the treatment of their choice in the patient preference trial (PPT) arm. Treatment protocols, data collection and follow-up were the same for all participants.Main outcome measures Primary outcome was reduction in Pregnancy Unique Quantification of Emesis (PUQE) score 48 hours after starting treatment. Secondary outcome measures were duration of treatment, improvement in symptom scores and ketonuria at 48 hours, reattendances within 7 days of discharge and comparison of symptoms at 7 days postdischarge.Results 152/174 eligible women agreed to participate with 77/152 (51%) recruited to the RCT and 75/152 (49%) to the PPT.Patients were initially compared in four groups (randomised IP, randomised OP, non-randomised IP and non-randomised OP). Comprehensive cohort analysis of participants in the randomised group (RCT) and non-randomised group (PPT) did not demonstrate any differences in patient demographics or baseline clinical characteristics. Pooled analysis of IP versus OP groups showed no difference in reduction in PUQE score at 48 hours (p=0.86). There was no difference in change in eating score (p=0.69), drinking score (p=0.77), well-being rating (p=0.64) or reduction in ketonuria (p=0.47) at 48 hours, with no difference in duration of index treatment episode (p=0.83) or reattendances within 7 days (p=0.52).Conclusions Ambulatory management is an effective direct alternative to IP management of s
AU  - Mitchell-Jones,N
AU  - Farren,J
AU  - Tobias,A
AU  - Bourne,T
AU  - Bottomley,C
DO  - 10.1136/bmjopen-2017-017566
PY  - 2017///
SN  - 2044-6055
TI  - Ambulatory versus inpatient management of severe nausea and vomiting of pregnancy: a randomized control trial with patient preference arm
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2017-017566
UR  - http://hdl.handle.net/10044/1/51356
VL  - 7
ER  -
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