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Reproduction Abstracts (2025) 4 011 | DOI: 10.1530/repabs.4.011

ICHG2024 International Colloquium on Hyperemesis Gravidarum 2024 Abstracts (22 abstracts)

Prednisolone weaning for hyperemesis gravidarum treatment - slow and steady leads to success

Kathryn Filipczuk 1,* , Penelope Fotheringham 1,2 , Natalie Cromer 1 , Debra Kennedy 1 & Delwyn Cupitt 1


1 MotherSafe, The Royal Hospital for Women, Randwick, Australia; 2 University of Sydney, Camperdown, Australia
Email Address: [email protected] (Kathryn Filipczuk)


Background: Prednisolone is a third-line oral antiemetic for hyperemesis gravidarum (HG) which can be considered if other treatments have failed. Current HG guidelines leave significant scope for interpretation with respect to prednisolone weaning advice. In NSW, Australia, a specialized medicines information telephone service received 1193 calls relating to NVP/HG, from consumers and healthcare professionals, between April-2023 and June-2024.

Objective: To increase awareness and understanding of how to dose and wean prednisolone slowly for HG, to achieve significant and sustained reduction in severe HG symptoms.

Method: Specialized staff were trained to assess symptoms and provide evidence-based advice regarding treatments. Patients were offered follow-up calls to assess progress. For prednisolone weaning advice, international NVP/HG guidelines were reviewed in detail. Throughout the literature, there were variations in weaning practices, and a gap in specific practice points to guide prednisolone weaning, particularly slower weaning. To address this, we developed a step-by-step, evidence-based guide for weaning prednisolone slowly.

Results: Success of prednisolone weaning was evaluated through follow up calls. While following the slower prednisolone weaning protocol, patients reported a significant and sustained reduction in the intensity of nausea and frequency of vomiting and retching. Most patients described this as "life-changing" for their severe HG symptoms and quality of life.

Conclusion: Effective prednisolone weaning can significantly improve severe HG symptoms and quality of life. In the future, it would be useful if international HG guidelines include slower prednisolone weaning advice, and detailed practice points, to further assist with prednisolone weaning in the management of HG.

Keywords: HG, hyperemesis, prednisolone, weaning, pregnancy

Volume 4

International Colloquium on Hyperemesis Gravidarum 2024

Ventura, USA
06 Nov 2024 - 07 Nov 2024

Hyperemesis Education and Research Foundation 

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