Successful use of intravenous droperidol in hyperemesis following failure of sequential antiemetic therapy.

Nausea and vomiting in pregnancy is a common affliction, especially in the early trimesters. This is typically managed at home with doxylamine-pralidoxime or other home remedies. Many women, however, require additional adjuncts to control their symptoms. In this case we present a G2P0 female at 7 weeks gestation who arrived in the emergency department with persistent vomiting for several days. This patient already had a home medication regimen of multiple antiemetics. Additional treatment with ondansetron, prochlorperazine, and metoclopramide via IV administration as well as fluid administration resulted in minimal improvement in her symptoms in the emergency department. After stepwise escalation of antiemetic therapy and fluid resuscitation failed to provide relief, droperidol administration resulted in the rapid and complete resolution of her symptoms. This allowed for a safe discharge rather than admission for hyperemesis gravidarum. This case highlights the utility of droperidol as a rescue antiemetic in pregnancy when conventional therapies prove to be ineffective. This adds to the evidence supporting consideration of droperidol for refractory cases of nausea and vomiting and hyperemesis gravidarum in pregnancy. The purpose of this case report is to describe the safety and efficacy of droperidol in the treatment in refractory nausea and vomiting in pregnancy.