Summary of Management

RCEM and RCOG have produced the following resource to guide clinicians in the ED through the initial assessment, investigations, severity scoring and management of patients presenting with NVP.

Many patients can be managed safely in the community. The mainstay of treatment is oral antiemetics, oral rehydration, dietary advice to eat little and often, and rest with time off work.

Some Obstetric centres may be able to facilitate IV therapies via an Ambulatory Clinic, thereby avoiding admission, but this will depend on your local service provision.

Red flags that would warrant referral for admission

• Any PUQE score plus complications
• Inability to tolerate oral intake
• Unresponsiveness to outpatient or Emergency Department management
• Clinical dehydration
• Weight loss of >5%
• Comorbidities such as urinary tract infection, epilepsy, diabetes, HIV, hypoadrenalism, or psychiatric disorders; being exacerbated by uncontrolled nausea and vomiting. An inability to take regular medications would be concerning.