Ondansetron versus metoclopramide for managing hyperemesis gravidarum: A systematic review and meta-analysis of randomized controlled trials/Hiperemezis gravidarum tedavisinde ondansetron ve metoklopramidin karsilastirilmasi: Randomize kontrollü çalismalarin sistematik bir incelemesi ve meta-analizi

This investigation examined the efficacy of ondansetron (intervention) versus metoclopramide (control) in managing parturient females with hyperemesis gravidarum (HG), by pooling data from randomized controlled trials (RCTs) using a meta-analysis approach. From inception until January 2022, five information sources were screened: Cochrane Central Register of Controlled Trials, Google Scholar, Scopus, PubMed and Web of Science. Quality assessment was done through the Cochrane Risk of Bias (version 2) assessment tool. The mean difference (MD) with 95% confidence interval (CI) was used to summarize the continuous data in a fixed- or random-effects model, depending on the extent of between-study heterogeneity. Five RCTs were included, comprising a total of 695 patients (355 and 340 females were assigned to ondansetron and metoclopramide, respectively). Four RCTs had an overall "low" risk of bias, whereas one RCT had an overall "some concerns" due to lack of sufficient information about randomization. There was no significant difference between both groups regarding the pregnancy-unique quantification of emesis and nausea score [MD=0.23, 95% CI (-0.42, 0.88), p=0.49], length of hospital stay [MD=-0.17 days, 95% CI (-0.35, 0.02), p=0.08], the number of doses of drug received [MD=0.45, 95% CI (-0.08, 0.98), p=0.10], and duration of intravenous fluids [MD=-1.73 hours, 95% CI (-5.79, 2.33), p=0.40]. Among parturient females with HG, there was no substantial difference in efficacy between both agents. Nevertheless, ondansetron is favored over metoclopramide in view of its trending therapeutic efficacy and better safety profile. Keywords: Ondansetron, metoclopramide, hyperemesis gravidarum, nausea, vomiting Randomize kontrollü çalismalarin (RKÇ) bu sistematik derleme ve meta-analizi, hiperemezis gravidarumlu (HG) gebe kadinlarin tedavisinde ondansetronun (müdahale) metoklopramide (kontrol) karsi etkinligini incelemeyi amaçlamistir. PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials ve Google Akademik veritabanlari, baslangiçtan Ocak 2022'ye kadar tarandi. Dahil edilen çalismalarin yanlilik riski Cochrane Collaboration aracina (versiyon 2) göre degerlendirildi. Çalisma sonuçlari, sabit veya rastgele etkiler modeli altinda %95 güven araligi (GA) ile ortalama fark (MD) olarak özetlendi. Toplam 695 hastadan olusan bes RKÇ dahil edildi (355 katilimci ondansetron ve 340 katilimci metoklopramid ile tedavi edildi). Dört RKÇ'nin gene