Effect of Acupressure at P6 on Nausea and Vomiting in Women with Hyperemesis Gravidarum: A Randomized Controlled Trial

Abstract

Hyperemesis gravidarum is characterized by severe nausea and vomiting. This study aims to illustrate the efficacy of acupressure at P6 in treating nausea and vomiting in hyperemesis gravidarum. This parallel randomized controlled trial was conducted from 2016–2017 in a tertiary hospital. Hospitalized women with ≤16 weeks of gestation and moderate to severe nausea and vomiting classified using a modified PUQE score were randomly assigned in a 1:1 ratio to either apply an acupressure wristband at the P6 point three times daily or to receive regular doses of intravenous antiemetics. The primary outcome was differences in modified PUQE scores among the groups. The secondary outcomes were differences in the rate of urine ketone clearance and the frequency of requiring rescue antiemetics. Ninety women were equally randomized into two groups, with no dropout. There was a statistically significant difference in the degrees of nausea and vomiting between the groups at 8, 16, and 24 hours post-admission (p8hours= 0.001, p16hours = 0.006, and p24hours = 0.001). The requirement of antiemetics and the rate of urine ketone clearance between the two groups were also statistically significant, at p = 0.001 and p = 0.02 respectively. There were no side effects in either group. The P6 acupressure was efficacious in alleviating nausea and vomiting among hyperemesis gravidarum women. The trial was retrospectively registered on ClinicalTrials.gov (NCT05175079).

The efficacy and safety of complementary and alternative medicine in the treatment of nausea and vomiting during pregnancy: A systematic review and meta-analysis

“…A total of 33 articles ( 24 – 56 ) were included in this paper, of which 24 RCTs ( 24 , 26 – 30 , 33 , 35 , 37 – 44 , 46 , 49 – 53 , 55 , 56 ) were analyzed for quantitative analysis due to sufficient sample size data. The remaining 9 articles ( 25 , 31 , 32 , 34 , 36 , 45 , 47 , 48 , 54 ) were about side effects, for which there were only descriptive discussions provided due to the small sample size data.…”

“…The included RCTs were published from 2002 to 2022. Eleven ( 24 , 27 – 29 , 31 , 33 , 35 , 36 , 38 , 39 , 45 ) were conducted in Iran, five ( 25 , 30 , 37 , 40 , 41 ) in Thailand, five ( 26 , 32 , 47 , 49 , 55 ) in Australia, four ( 43 , 51 – 53 ) in China, two ( 42 , 44 ) in Malaysia, two ( 46 , 54 ) in the UK, one ( 50 ) in Sweden, one ( 34 ) in Indonesia, one ( 48 ) in the USA, and one ( 56 ) in Croatia. The sample sizes of the included RCTs ranged from 18 to 340.…”

“…Eight articles ( 24 , 29 , 31 , 34 , 41 , 42 , 48 , 49 ) did not use allocation concealment, so they were judged as “N”, and the other five articles ( 43 , 46 , 51 – 53 ) did not mention allocation concealment, so were judged as “NI”. In terms of random sequence, the results showed that 57.5% of the articles ( 25 – 28 , 30 , 32 , 33 , 35 – 39 , 44 , 45 , 47 , 50 , 54 – 56 ) were judged as “low risk”, 18.0% as “some concern” ( 40 , 43 , 46 , 51 – 53 ) and 24.5% as “high risk” ( 24 , 29 , 31 , 34 , 41 , 42 , 48 , 49 ). All articles did not deviate from the intended interventions and were therefore judged to be “low risk”.…”

“…All articles had no data loss or data loss within acceptable limits, so they were judged to be “low risk”. For the measurement of results, the results showed that 45.5% of the articles ( 24 – 26 , 29 , 31 , 32 , 34 , 36 , 38 , 40 – 43 , 46 , 48 – 51 ) were judged as “high risk” and 54.5% ( 27 , 28 , 30 , 33 , 35 , 37 , 39 , 44 , 45 , 47 , 52 – 56 ) as “low risk”. Thirty articles ( 25 – 28 , 30 – 55 ) did not elaborate on the pre-planned or detailed full protocol, so were judged to be “NI”.…”

“…For the selection of the reported result, our results showed that 93.9% of the articles ( 25 – 28 , 30 – 56 ) were judged as “some concern” and 6.1% as “low risk” ( 24 , 29 ). To summarize the risk assessment results of all sections, we could see that 42.4% ( 28 , 30 , 33 , 35 , 37 , 39 , 44 , 45 , 47 , 52 – 56 ) of the articles were “some concern” and 57.6% ( 24 – 27 , 29 , 31 , 32 , 34 , 36 , 38 , 40 – 43 , 46 , 48 – 51 ) were “high risk”.…”