Late vomiting of pregnancy can persist despite initial antiemetic management. When earlier antiemetic options have failed to achieve adequate control, or have not been tolerated, a further pharmacotherapeutic step is indicated.
When does this protocol apply? This is a fourth-line pharmacotherapy approach, used specifically when other antiemetics have been ineffective or poorly tolerated.
Where reflux is identified as a contributing factor, addressing it alongside antiemetic therapy may further improve symptoms of nausea and vomiting.
Approach (partial): Management at this stage centres on a targeted antiemetic agent administered on a scheduled basis. When reflux is contributing to symptoms, an additional treatment addressing it may be incorporated. The complete regimen — including agent selection, dosing, route, and frequency — is contained in the full protocol.