A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. Effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Acupressure and vitamin B6 to relieve nausea and vomiting in pregnancy: a randomized study. Menstruation increases the risk of nausea and vomiting after laparoscopy. A prospective randomized study. Efficacy of P6 acupressure in the treatment of nausea and vomiting during pregnancy. Comparison of three outpatient regimens in the management of nausea and vomiting in pregnancy. Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study.
To evaluate the effectiveness of low-level nerve stimulation therapy over the volar aspect of the wrist at the P6 point to treat nausea and vomiting in early pregnancy.
                Pregnant volunteers (n = 230) with symptoms of mild to severe nausea and vomiting between 6 and 12 weeks' gestation participated in a 21-day clinical trial. Participants were randomly assigned to receive a device for nerve stimulation therapy or an otherwise identical but nonstimulating placebo device. The primary outcome measure was self-recorded symptoms according to the Rhodes Index of Nausea, Vomiting, and Retching (Rhodes Index). Secondary outcome measures were medication use, weight gain, and presence of urinary ketones.
                Baseline characteristics were similar in both groups. A total of 187 women (81%) completed the trial. Pretreatment Rhodes Index scores for the entire population demonstrated no significant differences between study and control groups. The time-averaged change in Rhodes Index total experience of 6.48 for the study group was significantly better than the control value of 4.65 (P =.02). Study patients gained more weight than controls (2.9 versus 1.2 lb, P =.003). There were no statistically significant differences in medication use or urinary ketone measurements.
                Nerve stimulation therapy is effective in reducing nausea and vomiting and promoting weight gain in symptomatic women in the first trimester of pregnancy. To evaluate the effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy.
                Ninety-eight volunteer pregnant women with symptoms of nausea and vomiting in early pregnancy before 14 weeks gestation were enrolled. The participants were randomized into two groups: treatment group and control group. Each patient in the treatment group received magnet pellets, placed at both auricles. They were taught to start acupressure from the third to the sixth day. Outcome measurement was Rhodes index score, which describe the severity and frequency of nausea and vomiting in the form of a questionnaire. The patients from both groups were asked to complete and return the forms including the amount of anti-emetic drug taken. Mean Rhodes index score and total number of anti-emetic drug taken from day 4-6 were used to compare the treatment effect. Student's t test, Chi-square test and Mann-Whitney U test were used for statistical analysis.
                Ninety-one pregnant women who returned the questionnaires were evaluated. The Rhodes index scores of the treatment group were lower than that of the control group especially after day 4 to day 6 when the acupressure was started. However when comparing the mean score between the two groups, there were no statistically significant differences (p > 0.05). The total amount of anti-emetic tablets in day 4-6 after acupressure intervention was compared and there were no statistically significant differences (p > 0.05) between the groups.
                Auricular acupressure therapy in treatment of nausea and vomiting in early pregnancy may not relieve nausea and vomiting in early pregnancy and need further clinical research to confirm the effectiveness. To evaluate the effectiveness of acupressure in reducing nausea and vomiting of pregnancy.
                Symptomatic pregnant women were randomized to one of two acupressure groups: one treatment group using an acupressure point (PC-6) and one sham control group using a placebo point. Subjects were blind to the group assignment. Each evening for 10 consecutive days, the subjects completed an assessment scale describing the severity and frequency of symptoms that occurred. Data from the first 3 days were used as pre-treatment scores. Beginning on the morning of the fourth day, each subject used acupressure at her assigned point for 10 minutes four times a day. Data from day 4 were discarded to allow 24 hours for the treatment to take effect. Data from days 5-7 were used to measure treatment effect.
                Sixty women completed the study. There were no differences between groups in attrition, parity, fetal number, maternal age, gestational age at entry, or pre-treatment nausea and emesis scores. Analysis of variance indicated that both groups improved significantly over time, but that nausea improved significantly more in the treatment group than in the sham control group (F1,58 = 10.4, P = .0021). There were no differences in the severity or frequency of emesis between the groups. There was a significant positive correlation (r = 0.261, P = .044) between maternal age and severity of nausea.
                Our results indicate that acupressure at the PC-6 anatomical site is effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women. Nausea and vomiting in early pregnancy are troublesome symptoms for some women. We undertook a single blind randomized controlled trial to determine whether acupuncture reduced nausea, dry retching, and vomiting, and improved the health status of women in pregnancy.
                The trial was undertaken at a maternity teaching hospital in Adelaide, Australia, where 593 women less than 14 weeks' pregnant with symptoms of nausea or vomiting were randomized into 4 groups: traditional acupuncture, pericardium 6 (p6) acupuncture, sham acupuncture, or no acupuncture (control). Treatment was administered weekly for 4 weeks. The primary outcomes were nausea, dry retching, vomiting, and health status. Comparisons were made between groups over 4 consecutive weeks.
                Women receiving traditional acupuncture reported less nausea (p < 0.01) throughout the trial and less dry retching (p < 0.01) from the second week compared with women in the no acupuncture control group. Women who received p6 acupuncture (p < 0.05) reported less nausea from the second week of the trial, and less dry retching (p < 0.001) from the third week compared with women in the no acupuncture control group. Women in the sham acupuncture group (p < 0.01) reported less nausea and dry retching (p < 0.001) from the third week compared with women in the no acupuncture group. No differences in vomiting were found among the groups at any time.
                Acupuncture is an effective treatment for women who experience nausea and dry retching in early pregnancy. A time-related placebo effect was found for some women. To compare the effectiveness of acupressure and vitamin B6 in the outpatient treatment of nausea and vomiting in early pregnancy.
                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.
                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.
                Acupressure therapy is not more effective than vitamin B6 in reducing nausea and vomiting in symptomatic women in the first trimester of pregnancy. Several factors may influence the incidences of postoperative nausea and vomiting. In women, one of these factors may be the timing of their surgery in relation to their menstrual cycle. The purpose of this study was to assess the effect of menstruation and efficacy of the antiemetic droperidol on postoperative nausea and vomiting.
                In a prospective randomized double-blind clinical trial, 100 female patients who were scheduled for laparoscopic tubal sterilization were stratified on the basis of the date of their last menses into menstrual (days 1-8) and nonmenstrual (days 9-28) groups. Patients in both groups were then randomized to receive placebo or 10, 20, or 30 micrograms/kg droperidol before induction of anesthesia, and data were obtained for 24 h after completion of their surgery.
                Nausea and vomiting were reported in 55 patients, and the risk was 2.92 times greater in the menstrual group (71.4%) than in the nonmenstrual group (46.2%; (P = .013). Droperidol (30 micrograms/kg) reduced the incidence of vomiting from 47.1% (placebo) to 13.3% in the nonmenstrual group (P = .045) but had no effect in the menstrual group. Five prognostic variables (menstrual stratum, droperidol, age 30 yr or younger, weight 65 kg or less, and history of nausea and vomiting) for postoperative nausea and vomiting were tested by stepwise logistic regression. Menstrual stratum was the only variable identified as a significant (P = .017) predictor, having a percent probability equal to 2.21.
                The risk of postoperative nausea and vomiting is increased in women undergoing laparoscopic tubal sterilization during the first 8 days of their menstrual cycle, and droperidol up to 30 micrograms/kg is not as effective in these patients. Our purpose was to investigate the efficacy of P6 acupressure in reducing or relieving symptoms of nausea with or without vomiting and retching during pregnancy.
                Symptomatic pregnant volunteers (n=161) participated in a 7-day community-based clinical trial. All participants were assigned to one of three groups (i.e., P6 acupressure, placebo [acupressure bands inappropriately placed], or control) on the basis of a process of blocked randomization. Data were analyzed by error bar charts and analysis of variance of difference scores.
                Of 161 women, 149 (92.5%) completed the protocol. Irrespective of group assignment, participants reported significant decreases in nausea (p<0.0009) and vomiting or retching (p<0.0009). However, there was no differential treatment effect as a result of acupressure.
                There was no apparent medical benefit from the use of P6 acupressure. Our findings differ from other recently published studies that did not include a control group. This study compares pyridoxine-metoclopramide combination therapy to prochlorperazine and promethazine monotherapies in the outpatient treatment of nausea and vomiting in pregnancy.
                In total, 174 first trimester, singleton pregnancies were evaluated for nausea and vomiting. Patients were prospectively randomized into three treatment groups: pyridoxine-metoclopramide, prochlorperazine, or promethazine. Prior to, and on the third day, patients recorded their subjective responses to the given treatment and their number of emesis episodes. The three treatment groups were compared for therapy response.
                There were no differences in the number of emesis episodes prior to treatment. Both subjective and objective responses to treatment differed among the three groups when comparing the combination therapy to the monotherapies (p<0.05).
                Combination therapy with pyridoxine and metoclopramide appears to be superior to either monotherapy in the treatment of nausea and vomiting in pregnancy. 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.
                A randomized, placebo-controlled, pilot study involving 60 women.
                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.
                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.
Given the high prevalence of nausea and vomiting in early pregnancy, health professionals need to provide clear guidance to women, based on systematically reviewed evidence. There is a lack of high-quality evidence to support that advice. The difficulties in interpreting the results of the studies included in this review highlight the need for specific, consistent and clearly justified outcomes and approaches to measurement in research studies.