Effect of acupressure by Sea-Bands on nausea and vomiting of pregnancy

OBJECTIVE: To determine the effect of continuous acupressure at P6 applied by Sea-Bands with acupressure buttons on the frequency and severity of nausea and vomiting of pregnancy during the 1 st trimester. DESIGN: A two-group, quasi-experimental, posttest-only and posttest-repeated measure. SETTING: Seventeen medical clinics or offices in southern Michigan. PARTICIPANTS: Convenience sample of English-speaking, healthy pregnant women in their 1 st trimester, who had at least one episode of nausea, vomiting, or both before their prenatal clinic/office visit where they were recruited. After being accepted for the study, the women were randomly assigned to treatment or placebo groups. INTERVENTION: Treatment group 1 applied SeaBands with acupressure buttons to both wrists for 4 days and removed the Sea-Bands for 3 subsequent days. Placebo group 2 applied the Sea-Bands without acupressure buttons to both wrists on the same time schedule as group 1. MAIN OUTCOME MEASURE: Self-report daily diaries of the number of times per day that participants experienced nausea, the severity of nausea, the number of vomiting episodes per day, and the severity of vomiting. RESULTS: Mann-Whitney U procedures revealed that the treatment group had significantly less frequency and severity of nausea and vomiting of pregnancy while wearing the Sea-Bands than did the placebo group. The treatment group also had significantly less frequency and severity of nausea and vomiting of pregnancy while wearing the SeaBands than when not wearing the Sea-Bands. CONCLUSIONS: Sea-Bands with acupressure buttons are a noninvasive, inexpensive, safe, and effective treatment for the nausea and vomiting of pregnancy.     

Effect of acupressure on nausea and vomiting during pregnancy

This paper sought to determine the efficacy of acupressure application in pregnant women suffering from nausea, with or without associated vomiting, who were unable to receive conventional medication for these symptoms. Sampling consisted of pregnant women complaining of nausea with or without vomiting. The study was controlled by the Maternity and Child Hospital in Istanbul between March 2004 and March 2005. The treatment group comprised 26 women; 25 in the control arm and 24 women were assigned to the placebo arm. The study occurred over a 9-day period. During this time, the treatment group applied acupressure bands to P(6) acupressure point on days 4-6 of the study with the placebo group receiving acupressure bands to a sham acupressure point, on the upper side of their wrists. RESULTS AND CONCLUSION: Acupressure would appear to be effective in symptom control, and alleviation and placebo effects in reducing the symptoms of nausea and vomiting during pregnancy.     

Prevention of nausea and vomiting during termination of pregnancy

Background

Postoperative nausea and vomiting (PONV) is common in women undergoing dilatation and curettage under general anesthesia for pregnancy termination, and many studies suggest treating these women prophylactically for PONV.

Objectives

Reviewing the antiemetics used over the past 20 years for this indication and comparing their efficacy.

Search strategy

We performed MEDLINE and EMBASE searches for articles published from January 1980 through June 2009. The search terms were complications, nausea, vomiting, antiemetics, anesthetics, surgery, dilatation, curettage, pregnancy, and women.

Selection criteria

We selected the studies of the antiemetics droperidol, metoclopramide, hydroxyzine, propofol, dexamethasone, ondansetron, and ramosetron when used for the stated indication. When assessing drug efficacy, we compared the antiemetics used at the time the article was written.

Data collection and analysis

We reviewed the selected studies, presented the reported incidence rates of PONV for each drug, and presented and interpreted the P values reported for the different comparisons.

Main results

Although all antiemetics assessed decreased the incidence of PONV, the combination of dexamethasone and droperidol seems to be the most effective in preventing PONV.

Conclusions

All antiemetics used in the last 20 years to prevent PONV are effective (some more than others) in women undergoing dilatation and curettage for pregnancy termination. However, there is a need for benefit and risk analyses of the different treatments.     

Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study

OBJECTIVE: To compare the antiemetic effect of acupressure at the Neiguan point (P6) in a group of healthy women with normal pregnancy and nausea and vomiting during pregnancy (NVP) with a similar group receiving acupressure at a placebo point and another, similar group not receiving any treatment. STUDY DESIGN: A randomized, placebo-controlled, pilot study involving 60 women. RESULTS: It is possible to reduce NVP significantly with acupressure at P6 as compared to acupressure at a placebo point or no treatment at all in healthy women with normal pregnancies. Relief from nausea appeared one day after starting treatment in both the P6 and placebo groups but lasted for only six days in the placebo group. The P6 group, however, experienced significantly less nausea after 14 days as compared to the other two groups. CONCLUSION: This study involved 60 healthy women with normal pregnancy and suffering from NVP. According to the results, in healthy women with normal pregnancy it is possible to reduce NVP significantly at P6 as compared to acupressure at a placebo point and to no treatment.     

Acupressure and vitamin B6 to relieve nausea and vomiting in pregnancy: a randomized study

Objective To compare the effectiveness of acupressure and vitamin B6 in the outpatient treatment of nausea and vomiting in early pregnancy. Study design Pregnant volunteers with symptoms of mild to moderate nausea and vomiting between 6 and 12 weeks’ gestation participated in a 7-day clinical trial. Participants were randomly assigned to receive a device for acupressure therapy and placebo drug or an otherwise identical but non-stimulating placebo device and vitamin B6. The primary outcome measure was self-recorded symptoms according to Rhodes index. Secondary outcome measures were weight gain and medication use. Results The mean change in Rhodes index was not significantly different between the two groups. There were no statistically significant differences in weight gain and medication use between the two groups. Conclusion Acupressure therapy is not more effective than vitamin B6 in reducing nausea and vomiting in symptomatic women in the first trimester of pregnancy.     

Helicobacter pylori and severe nausea and vomiting during pregnancy

Helicobacter pylori is a bacterial infection of the stomach, which may aggravate nausea and vomiting in pregnancy. Studies have found conflicting evidence of the role of H. pylori in severe nausea and vomiting in pregnancy and hyperemesis gravidarum. Several women suffering from weight loss and experiencing continued nausea and vomiting were tested for H. pylori antibody during their pregnancy. This article reviews the outcomes of women with both positive and negative H. pylori tests, the treatment of H. pylori, and its controversial role in managing severe nausea and vomiting in pregnancy.     

Comparing ginger and vitamin B6 for the treatment of nausea and vomiting in pregnancy: a randomised controlled trial

Objective

to compare the effectiveness of ginger and vitamin B6 for the treatment of nausea and vomiting in early pregnancy.

Methods

double-blind randomised controlled trial. Pregnant women with nausea, who first attended the antenatal clinic at or before 17 weeks gestation, were invited to participate in the study. Over a 3-month period, 70 women were randomised to receive either ginger 1 g/day or vitamin B6 40 mg/day for 4 days. Subjects graded the severity of their nausea using a visual analogue scale, and recorded the number of vomiting episodes in the 24 hours before treatment and during 4 consecutive days while taking treatment. At 7-day follow-up, women reported any changes in the severity of their symptoms.

Results

compared with baseline, the decrease in the visual analogue scores of post-therapy nausea in the ginger group was significantly greater than that for the vitamin B6 group (p=0.024). The number of vomiting episodes decreased in both groups, and there was no significant difference between the groups. In the ginger group, 29/35 women reported an improvement in nausea symptoms, compared with 23/34 women in the vitamin B6 group (p=0.52).

Conclusion

ginger is more effective than vitamin B6 for relieving the severity of nausea, and is equally effective for decreasing the number of vomiting episodes in early pregnancy.     

Maternal alcohol and tobacco consumption and their association with nausea and vomiting during pregnancy.

Nausea and vomiting during pregnancy (NVP) has been associated with favorable pregnancy outcome, though little is known about factors influencing its occurrence. In this study, information on NVP in 210 patients at a west coast health maintenance organization was obtained. Smoking and alcohol consumption before and during pregnancy were also estimated in two personal interviews during gestation. In all, 72% of the subjects had NVP in the first 4 months of pregnancy. Smokers had significantly less NVP than non-smokers (52% vs. 79%). Furthermore, NVP in smokers was negatively associated with alcohol consumption before and during pregnancy, with the stronger relation being for alcohol reported in the 6 months before pregnancy; only 46% of smokers drinking more than 1/2 fl. oz. of absolute alcohol daily in this period reported NVP, while 68% of smokers drinking less had NVP. For non-smokers, there was no relation between alcohol use in any period and NVP. The risk of NVP associated with pre-pregnancy drinking was not related to any change in alcohol consumption after conception. These results suggest an interaction between NVP, smoking, and reported alcohol consumption. The association of favorable pregnancy outcome with NVP may be in part a reflection of moderation in maternal alcohol and tobacco use.     

A literature review of the effectiveness of ginger in alleviating mild-to-moderate nausea and vomiting of pregnancy

Mild-to-moderate nausea and vomiting of pregnancy affects up to 80% of all pregnancies. Concern about antiemetic use and the time-limited nature of symptoms has restrained the development of effective treatment approaches, yet supportive, dietary, and lifestyle changes may be ineffective. This article reviews 4 recent well-controlled, double-blind, randomized clinical studies that provide convincing evidence for the effectiveness of ginger in treating nausea and vomiting of pregnancy. It also provides a dosage update for the various forms of ginger.     

High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals

Objective

The goal of this study was to determine the prevalence of severe nausea and vomiting of pregnancy/hyperemesis gravidarum among relatives of affected individuals.

Study design

Family history data were obtained on 1224 self-reported cases of hyperemesis gravidarum. Cases completed an online survey administered by the Hyperemesis Education and Research Foundation between 2003 and 2006.

Results

Approximately 28% of cases reported their mother had severe nausea and vomiting or hyperemesis gravidarum while pregnant with them. Of the 721 sisters with a pregnancy history, 137 (19%) had hyperemesis gravidarum. Among the most severe cases, those requiring total parenteral nutrition or nasogastric feeding tube, the proportion of affected sisters was even higher, 49/198 (25%). Nine percent of cases reported having at least two affected relatives including sister(s), mother, grandmother, daughters, aunt(s), and cousin(s).

Conclusion

There is a high prevalence of severe nausea and vomiting of pregnancy/hyperemesis gravidarum among relatives of hyperemesis gravidarum cases in this study population. Because the incidence of hyperemesis gravidarum is most commonly reported to be 0.5%, this study provides strong but preliminary evidence for a genetic component to extreme nausea and vomiting of pregnancy.     

Survey of medicinal cannabis use among childbearing women: patterns of its use in pregnancy and retroactive self-assessment of its efficacy against 'morning sickness'

A majority of women experience some nausea and/or vomiting during pregnancy. This condition can range from mild nausea to extreme nausea and vomiting, with 1-2% of women suffering from the life-threatening condition hyperemesis gravidarum. Cannabis (Cannabis sativa) may be used therapeutically to mitigate pregnancy-induced nausea and vomiting. This paper presents the results of a survey of 84 female users of medicinal cannabis, recruited through two compassion societies in British Columbia, Canada. Of the seventy-nine respondents who had experienced pregnancy, 51 (65%) reported using cannabis during their pregnancies. While 59 (77%) of the respondents who had been pregnant had experienced nausea and/or vomiting of pregnancy, 40 (68%) had used cannabis to treat the condition, and of these respondents, 37 (over 92%) rated cannabis as 'extremely effective' or 'effective.' Our findings support the need for further investigations into cannabis therapy for severe nausea and vomiting during pregnancy.