What is the first-line treatment of hyperemesis gravidarum?

Hyperemesis gravidarum involves severe, persistent nausea and vomiting during pregnancy. This first-line protocol addresses the condition through a structured combination of non-pharmacological and pharmacological measures, with the clinical goal of achieving reduction or resolution of nausea and vomiting.

Initial management centres on dietary and lifestyle modifications — including staying hydrated, adjusting meal frequency and volume, and identifying and avoiding personal nausea triggers. These are combined with first-line pharmacotherapy; evidence supports the use of a vitamin B6-based combination to reduce the severity and duration of nausea and vomiting of pregnancy.

The complete regimen — including agent selection, dosing guidance, and titration sequence — is available in the full structured protocol below.

Reduction or resolution of nausea and vomiting of pregnancy.