American Board of Family Medicine (ABFM) Practice Exam

Which of the following is considered first-line treatment for nausea and vomiting in pregnancy?

1. Doxylamine

2. Vitamin B6

3. Metoclopramide

4. Ondansetron

The correct answer is: Vitamin B6

The first-line treatment for nausea and vomiting in pregnancy is Vitamin B6, also known as pyridoxine. This approach is based on its established safety profile and efficacy in alleviating mild to moderate nausea and vomiting, often referred to as morning sickness. Vitamin B6 has been studied extensively in pregnant populations, demonstrating a significant reduction in symptoms without any adverse effects on the developing fetus. While doxylamine can also be effective and is sometimes used in combination with Vitamin B6, it is not typically the primary recommendation for initial management. Metoclopramide and ondansetron are often reserved for more severe cases of nausea and vomiting, such as hyperemesis gravidarum, due to their stronger pharmacological effects and potential side effects, making them less suitable as first-line options during pregnancy.