Doctors should be ready to treat women who suffer from severe "morning sickness" during pregnancy, experts said today.
Anti-histamines are regarded as a safe treatment while vitamin B6 may help, according to the journal The Obstetrician and Gynaecologist.
The conclusions challenge official guidance in the UK which says vitamin B6 – pyridoxine – should not be used.
This advice from the National Institute of Health and Clinical Excellence is at odds with US and Canadian guidelines which support up to 40mg a day of the vitamin, according to Dr Roger Gadsby, a GP based at Warwick University, UK.
Dr Gadsby says no link has been found between B6 and malformations of the foetus – although there is concern that high doses might be toxic.
Ever since the thalidomide scandal 50 years ago in the UK, doctors have been wary of trying to treat morning sickness with drugs.
Discussing severe nausea and vomiting in pregnancy, he says many women find nausea to be the most distressing part.
Dr Gadsby said: "Nausea and vomiting during pregnancy can cause significant illness. However, early treatment can be an effective way of preventing the onset of severe symptoms and can reduce the number of hospital admissions."
Journal editor Jason Waugh said: "This review looks back over a number of important studies assessing the use of different treatments and highlights the need for pre-emptive treatment.
"Severe symptoms of the condition can lead to women being unable to undertake their normal day-to-day activities."
* A second report in the journal warns of the risks of performing operations on morbidly obese women.
Patrick Hogston, of the Queen Alexandra Hospital, Portsmouth, says doctors can often try weight loss and other therapies before attempting gynaecological operations on these women.
Mr Waugh said: "Obesity is an increasing problem. It is essential that staff involved in treating obese patients are fully trained and that there are departmental protocols and guidelines in place to advise on the management of these patients."
Gadsby R, Barnie-Adshead T. Severe nausea and vomiting of pregnancy: should it be treated with appropriate pharmacotherapy? The Obstetrician & Gynaecologist 2011;13:107-111.
Biswas N, Hogston P. Surgical risk from obesity in gynaecology. The Obstetrician & Gynaecologist 2011;13:87-91.
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