It is quite common to witness heartburn due to gastroesophageal reflux during pregnancy.

Rayburn et al conducted a prospective clinical trial to evaluate if ranitidine, along with antacids, was more effective than antacids alone among pregnant women having heartburn. The study included women at 20 weeks’ gestation or beyond and the study duration was 3 weeks.

During the initial week, the participants received antacid therapy only. In case of four or more episodes of moderate to severe heartburn, in spite of 1-week treatment with antacid, the patients were randomized to receive antacid and either a placebo or ranitidine 75 mg for the second and third week.

A total of 50 women met the study criteria. Ten of them withdrew and 10 had relief with antacids. Overall, 30 women continued the use of antacids and were randomized to receive either ranitidine (n=15) or a placebo (n=15).

• Heartburn intensity decreased from the baseline with antacid treatment during the first week of therapy and declined further with either combination during the second week. However, the decline in heartburn intensity was most significant with ranitidine and antacid combination therapy, in comparison with the baseline.
• Antacid use was reduced from the first week of antacid alone therapy to the second week, when either ranitidine or a placebo was added, from 42 per week to 30 per week.
• None of the patients taking ranitidine had any side effects, and the birth outcomes were favorable.

Ranitidine use appears to be justified in pregnant women having heartburn with inadequate response to antacids.

Source: Rayburn W, Liles E, Christensen H, Robinson M. Antacids vs. antacids plus non-prescription ranitidine for heartburn during pregnancy. Int J Gynecol Obstet. 1999;66:35-7.