Nausea and vomiting of pregnancy (NVP) is the most common medical condition in pregnancy, affecting an estimated 80% of all pregnant women. It is therefore surprising that very little research has been conducted over the last few decades focussing on the etiology of the condition, its characteristics, complications and management. Due to fears of teratogenesis, and following the removal of Bendectin (doxylamine-vitamin B6 combination) from the American market, very little advance has been made in developing pharmacological modalities to treat the symptoms of NVP.

In 1993, the Motherisk program at the Hospital for Sick Children in Toronto decided to focus on NVP as an important condition where most women are orphaned from the advances of therapies known to be effective for the mother and safe for the baby. Our counselling initiative, together with wide educational programs all over Canada, have led to substantial change among physicians and pregnant patients alike, and have resulted in decreased hospitalization rates for NVP in this country.

In October 1998, we organized, with the help of an unrestricted educational grant from Duchesnay Inc., Laval, Quebec, Canada, the First International Conference on NVP. Physicians and researchers who have shown a consistent track record of research and publications on this condition were invited. The reports by these colleagues make Part One of this volume; Part Two introduces selected papers written by members of the Motherisk team as part of its research focussed on NVP.

It is our intention to repeat this effort every third year, with the sincere conviction that communication among clinicians and scientists, together with the sharing of international experience and evidence, is the most effective tool to move quickly towards a better understanding of the biology of this condition and its management.

Gideon Koren, MD, FACCT, FRCPC

Raafat Bishai, MD, MSc, DCH

Toronto, Canada

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