AIM:To evaluate the efficacy of acupressure at the Neiguan point (Pericardium [P]6) as adjuvant treatment during inpatient management of severe nausea and vomiting in pregnancy.

METHODS:Low risk, spontaneously conceived singleton pregnancies were randomly assigned to a treatment group, who received an acupressure band placed at the Neiguan point (P6) or a placebo group who received an otherwise identical non-stimulating wristband. Participants wore the band for 12 h daily for the first three days of admission. The primary outcome measure was the severity of symptoms of nausea, vomiting and retching, recorded according to Pregnancy-Unique Quantification of Emesis and Nausea score.

RESULTS:There was a statistically significant improvement in Pregnancy-Unique Quantification of Emesis and Nausea scores from day 1 until day 3 of admission in the treatment group compared with the placebo. Patients who received Neiguan point acupressure also showed a significant improvement in their ketonuria scores. The treatment group required a shorter hospital stay compared with the placebo. The only reported side effect of the acupressure band was redness on the wrist.

CONCLUSIONS:The use of the acupressure band at the Neiguan point (P6) for 12 h daily for three days for inpatients with hyperemesis gravidarum significantly reduced the symptoms of nausea, vomiting and retching and ketonuria and led to a reduction in hospital stay. We recommend the use of the acupressure band at the Neiguan point (P6) as an adjunct/supplementary therapy to co-exist with the standard care of management for hyperemesis gravidarum, particularly in low-risk pregnant women.

BACKGROUND: Complementary medicine has become popular throughout many Western countries and is widely used by women across all stages of their life cycle. Acupuncture is used by women during their pregnancy, and research suggests that acupuncture may be used as an adjunct to their existing conventional care. The aim of this paper was to summarize the evidence examining the effectiveness of acupuncture during pregnancy and birthing, and to discuss its role as an adjunct treatment. METHODS: We conducted a systematic literature search using several electronic databases. We included all placebo-controlled randomized trials of parallel design, and systematic reviews that evaluated the role of acupuncture during pregnancy and birthing. A critical appraisal of clinical trials and systematic reviews was undertaken. RESULTS: The summarized findings indicated a small but growing body of acupuncture research, with some evidence suggesting a benefit from acupuncture to treat nausea in pregnancy. Findings from the review also highlighted promising evidence for the effectiveness of acupuncture to manage back and pelvic pain, acupuncture-type interventions to induce change in breech presentation, and pain relief in labor. The methodological quality of recent trials has improved, and the quality of systematic reviews was high. CONCLUSIONS: Interest is growing in the use of acupuncture to treat some complaints during pregnancy and childbirth, and evidence is beginning to consolidate that acupuncture may assist with the management of some complaints during pregnancy. However, definitive conclusions about its effectiveness cannot be reached and further research is justified.

BACKGROUND: Complementary medicine has become popular throughout many Western countries and is widely used by women across all stages of their life cycle. Acupuncture is used by women during their pregnancy, and research suggests that acupuncture may be used as an adjunct to their existing conventional care. The aim of this paper was to summarize the evidence examining the effectiveness of acupuncture during pregnancy and birthing, and to discuss its role as an adjunct treatment. METHODS: We conducted a systematic literature search using several electronic databases. We included all placebo-controlled randomized trials of parallel design, and systematic reviews that evaluated the role of acupuncture during pregnancy and birthing. A critical appraisal of clinical trials and systematic reviews was undertaken. RESULTS: The summarized findings indicated a small but growing body of acupuncture research, with some evidence suggesting a benefit from acupuncture to treat nausea in pregnancy. Findings from the review also highlighted promising evidence for the effectiveness of acupuncture to manage back and pelvic pain, acupuncture-type interventions to induce change in breech presentation, and pain relief in labor. The methodological quality of recent trials has improved, and the quality of systematic reviews was high. CONCLUSIONS: Interest is growing in the use of acupuncture to treat some complaints during pregnancy and childbirth, and evidence is beginning to consolidate that acupuncture may assist with the management of some complaints during pregnancy. However, definitive conclusions about its effectiveness cannot be reached and further research is justified.

INTRODUCTION:Nausea and vomiting are common problems during pregnancy. Previous studies have shown that stimulation at Neiguan (PC6) acupoint can be effective in controlling pregnancy-induced nausea and vomiting. However, more evidence is required for approving this method on controlling pregnancy-induced nausea and vomiting. The aim of this study was to determine the efficacy of PC6 acupoint pressure stimulation on the severity of nausea, vomiting, and retching in pregnant women.

METHOD:This randomized, multi-center clinical trial was conducted on pregnant women referring to Health Centers and Ommolbanin Hospital in Mashhad, Iran, during December 2016 to September 2017. Women with first singleton pregnancy and below 12 weeks were included. Patients were randomly allocated into three groups of (1) PC6 pressure (4 times a day, for 10 min), (2) sham acupressure, and (3) medication with vitamin B6 and metoclopramide. Assessment of severity of nausea, vomiting, and retching was done based on the Rhodes Index on the first and fifth day (before and after the intervention). Pearson chi-square test, one-way ANOVA, Kruskal-Wallis, and Wilcoxon tests were used for statistical analysis using SPSS version 18. This clinical trial was registered at the Iranian Registry of Clinical Trials (IRCT) with the code IRCT201512187265N6.

RESULTS:Ninety patients with a mean age of 26.40± 4.73 years were studied in 3 groups of 30. There was no significant difference between the 3 groups in terms of the severity outcomes before the intervention, while, after the intervention, the three groups were significantly different on the fifth day in terms of vomiting frequency, distress from retching, distress from vomiting, duration of nausea, distress from nausea, amount of vomiting, frequency of nausea, and frequency of retching (p<0.001 for each outcome). According to the linear regression analysis, the correlation between occupation with vomiting frequency (beta coefficient = 0.252) and nausea severity (beta coefficient = -0.213) was statistically significant.

CONCLUSION:It seems that PC6 acupoint pressure can reduce the severity of nausea, vomiting, and retching in pregnant women.