Consistency Treating Nausea in Pregnancy Could Save Money

Peter Russell

December 18, 2018

The NHS could save millions of pounds by offering better advice and more consistent treatment to women who experience nausea and vomiting during pregnancy, according to new research.

An observational study by the University of Warwick found that the cost to the health service of nausea and vomiting of pregnancy (NVP) is £62.4 million a year – higher than previous estimates.

The research suggested that recent guidelines issued by The Royal College of Obstetricians and Gynaecologists (RCOG) for managing the condition may not always be effective or adhered to.

NVP is the most prevalent medical condition associated with pregnancy, affecting up to 80% of pregnant women. Symptoms can range from mild nausea to the most severe form of vomiting, known as hyperemesis gravidarum (HG).

The Duchess of Cambridge experienced HG during her three pregnancies, which has increased awareness of the condition.

Analysis of CCG Statistics

The latest study, published in the British Journal of General Practice , was based on patients in the NHS Newcastle Gateshead Clinical Commissioning Group. Data was collected from GP practices, hospitals, and ambulance services.

Overall, 15.2% of pregnant women sought medical help because of NVP.

Among the main study findings were that:

  • Treatment varied significantly between GP practices, with 33.6% of women who asked their GPs for help returning for further advice because of persistent symptoms

  • There was an annual increase in women admitted to hospital for NVP symptoms, with increasing length of stay per admission

  • Almost half (44.6%) of the calls to 999/111 from women experiencing NVP symptoms resulted in an ambulance being dispatched

Treatment Variations

Prof Roger Gadsby from Warwick Medical School, who led the study, said: "The main message is that nausea and vomiting in pregnancy costs the NHS more than has been realised in the past.

"Our paper shows that there is wide variation in the management at general practice level.

"National guidelines on the management of nausea and vomiting in pregnancy were launched in 2016 and the first medication licensed to be used in pregnancy for treating nausea and vomiting has recently been launched. Reducing variation and improving management in the community would be a great benefit to women suffering from this underappreciated condition.

"Such variation could be reduced by better advice and appropriate prescribing from healthcare professionals. This could reduce ambulance callouts and hospital admissions so reducing the cost burden to the NHS."

The authors said that further research into the economic burden of NVP could focus on "accurately determining the variance in NVP hospital admission costs at a patient level, including factors such as severity of symptoms, length of stay, and use of outpatient services".

‘Nausea and vomiting of pregnancy and resource implications: the NVP Impact Study’, published in the British Journal of General Practice, 18 December 2018. Paper .

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