I noticed there were no preferences listed in the ALS PCS or the companion document for antiemetics during pregnancy. Is there a preference of one vs the other when administering an antiemetic to a pregnant patient?
Thank you for your question. The companion document contains some additional information that permits paramedics to use their clinical judgement as it pertains to the selection of either Dimenhydrinate or Ondansetron. Both medications are considered safe in this patient population; however, dimenhydrinate has years of data showing safety in all trimesters of pregnancy. Ondansetron has shown to be safe in all trimesters with a possible mild increase in oral cleft malformation (risk difference of 2.7 per 10000 births), for this reason, dimenhydrinate should be considered in pregnant patients.
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