Well here is the study that has had everyone talking for a while. Good old ondansetron category B now may cause congential malformations in the fetus. This study in the journal Reproductive Toxicology retrosp of 1349 infants concludes a risk for CV defect (septum specifically) is increased to a statistically significant degree. My favorite prior study looked at 608,000 pregnancies and concluded no malformation risk. This is in the NEJM. So I am much more likely to follow the recs of the huge NEJM study.

Now we could do more prospective studies of course to see if ondansetron is causing any true effects. And we can always use the promethazine, prochlorperazine class of drugs in these patients while in the ED or even for discharge. I still love good old extremely evidence-based ginger pills, also B6, diphenhydramine, not eating crap food, etc.

Discussion is welcome.