This protocol addresses hyperemesis gravidarum that has not responded adequately to initial management. Despite completing a full course of first-line treatment, nausea and vomiting of pregnancy persists and escalation is required.
Dietary and lifestyle modifications were implemented alongside first-line pharmacotherapy with Pyridoxine (Vitamin B6) and Doxylamine.
The target — reduction or resolution of nausea and vomiting of pregnancy — was not achieved, establishing the indication for the next treatment step.
When nausea and vomiting persist after first-line pharmacotherapy, the approach involves adding a second sedating antihistamine to the regimen.
The treatment goal is complete resolution of nausea and vomiting. Agent selection, route, dose, and frequency are specified in the full structured protocol.