Priority 6 from the Hyperemesis Gravidarum PSP

UNCERTAINTY: What are the immediate and long term effects of the various medications/treatments on the developing foetus throughout the various stages of pregnancy and in varying doses or combinations of treatments? (JLA PSP Priority 6)
Overall ranking 6
JLA question ID 0090/6
Explanatory note Not available for this PSP

Various studies and reviews of individual medications for particular exposure periods. For example, SR found: "first trimester ondansetron exposure is not associated with an overall statistically significant increased risk of congenital malformations or cardiovascular defects." ref: Balayla, J.; D'Alton, M. E. 2016 First trimester ondansetron exposure and the risk of major congenital malformations and heart defects: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology - Volume 1, Issue 0, pp. S177.  This doesn't answer the question on whether ondansetron is safe throughout pregnancy, third trimester or in what doses or in combination with other medication

Health Research Classification System category Reproductive health and childbirth
Extra information provided by this PSP
Original uncertainty examples Do any of the medicines harm the baby? ~ Does the type, dose and duration of medication have different effects on the baby depending on the time of the pregnancy the medication is used. For example, does ondansetron have a different (potential) effect on the baby if this is taken in the first trimester vs the last trimester? ~ Is this drugs cocktail really the best thing for baby? 
Submitted by Patients x 80 ~ Healthcare professionals x 19 ~ Carers x 2 ~ Offspring x 9 ~ Unknown x 3
PSP information
PSP unique ID 0090
PSP name Hyperemesis Gravidarum
Total number of uncertainties identified by this PSP. 65  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 9 October 2019