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Test clinici – Nausea in gravidanza


P6 acupressure reduces morning sickness

Dundee JW, Sourial FB, Ghaly RG, Bell PF.
“P6 acupressure reduces morning sickness”
Department of Anaesthetics, Queen’s University, Belfast, EIRE
JR Soc Med 1988, 81:456-7

OGGETTO E METODO: 350 donne nella fase iniziale della gravidanza sono state divise in tre gruppi: (1) acupressione esercitata su PC 6, (2) acupressione esercitata su un punto placebo, (3) nessuna terapia.

RISULTATI: Dopo quattro giorni di osservazione sono stati valutati i risultati: il gruppo 1, sottoposto a vera acupressione, mostrava una significativa riduzione della sintomatologia rispetto al gruppo 2 [p < 0-01]. Tale riduzione era ancor piu evidente nei confronti del gruppo 3 non sottoposto ad alcuna terapia [ p < 0.0005]. la significatività della differenza tra i risultati dei gruppi 1 e 2 dimostra l’effetto antiemetico dell’acupressione.

The efficacy of Seabands for the control of nausea and vomiting in pregnancy

Colleen Stainton M, Neff JA
“The efficacy of Seabands for the control of nausea and vomiting in pregnancy”
Faculty of Nursing, University of Calgary, Canada
School of Nursing, East Carolina University, USA
Pregnancy Healthcare Women Int, 1994; 15:563-75

OGGETTO E METODO: 27 donne gravide (tra la 5° e la 22° settimana di gestazione) sono state sottoposte ad applicazione di Sea-Band® allo scopo di controllare la sintomatologia dell’iperemesi gravidica.

RISULTATI: I risultati evidenziano una netta riduzione della nausea (50%), del vomito (50%) e dei conati (33%). Nel 31% delle donne vi e stata la scomparsa della sintomatologia, nel 60% il miglioramento e solamente nel 8% non si sono avute variazioni. La terapia si e dimostrata assai piu efficace se praticata all’insorgere della sintomatologia.

Effetto antiemetico nella gravidanza al primo trimestre dell’acupressione sul punto Nei-Kuan

De Aloysio D, Pennacchioni P
“Effetto antiemetico nella gravidanza al primo trimestre dell’acupressione sul punto Nei-Kuan”
Clinica Ostetrica e Ginecologica III, Universita di Bologna, Italia
Obstet Gynaecol 1992; 80(5): 852-4

OGGETTO E METODO: Lo studio randomizzato e controllato, eseguito in cross-over, e consistito nell’osservazione di due gruppi di 30 donne nel primo trimestre di gravidanza. I due gruppi sono stati sottoposti per 12 giorni all’applicazione di Sea-Band® e, per un uguale periodo, all’applicazione di Sea-Band® placebo (con bottone limitato).

RISULTATI: I risultati hanno evidenziato un significativo miglioramento [p < 0.05] della sintomatologia nel periodo in cui e stato applicato Sea-Band® rispetto al placebo. Non si sono, invece, riscontrate differenze di risultato nei sottogruppi in cui Sea-Band® era stato applicato solamente a destra o sinistra rispetto a quello in cui era posizionato bilateralmente.

Acupressure therapy for morning sickness

Hyde E
“Acupressure therapy for morning sickness”
American College of Nurse.Midwives, USA
J Nurse Midwifery 1989; 34:171-8

OGGETTO E METODO: Lo studio randomizzato e controllato e stato condotto in cross-over su 16 donne nei primi tre mesi di gravidanza, alle quali e stato applicato bilateralmente Sea-Band® una settimana alternativamente ai polsi (su Neiguan) e sui gomiti (placebo).

RISULTATI: i risultati dimostrano una significativa riduzione della sintomatologia nel periodo in cui le pazienti erano sottoposte alla corretta applicazione Sea-Band® rispetto al placebo [p < 0.25].

An evaluation of the use of Sea Bands in alleviating the nausea and vomiting of early morning sickness

Bayreuther J, Lewith GT, Pickering R
“An evaluation of the use of Sea Bands in alleviating the nausea and vomiting of early morning sickness”
Faculty of Medicine Southampton University, England
Complement Ther Med 1994; 2:70-76

PURPOSE: to assess by means of a blindy evaluated crossover study if acupressure at the P6 wrist point (active) is more effective than acupressure at the elbow (placebo) in reducing the nausea and vomiting in pregnancy.

METHOD: women were concacted through various Southampton G.P.s and women were given to pregnant women between 18-35 years. The women were randomly allocated to one of two groups, to wear Sea Bands on both wrists for seven days and then on both elbows for seven days, or visa-versa. Symptoms were recorded on daily visual analogue cards. There was a questionnaire to be completed at the beginning and the end of the two weeks. The credibility of the placebo was also assessed.

RESULTS: results show a significant decrease in nausea with acupressure at P6 compared to the placebo. Women were initially equally hopeful of both treatments working. They were significantly more confident in recommending P6 acupressure after treatment.

CONCLUSION: P6 acupressure is a good method of nausea control in pregnancy. A point further up the arm is a credible placebo.

Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study

Norheim AJ, Pedersen EJ, Fonnebo V, Berge L.
“Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study”
Havnegata General Practice, Harstad, Norway.
Scand J Prim Healthcare 2001(1); 19:43-7

OBJECTIVE: To find out whether acupressure wristband can alleviate nausea and vomiting in early pregnancy.

DESIGN: Double-blind, placebo-controlled study.

SUBJECTS: 97 women with mean gestational length completed 8-12 weeks.

MAIN OUTCOME MEASURES: Symptoms were recorded according to intensity, duration and nature of complaints.

RESULTS: 71% of women in the intervention group reported both less intensive morning sickness and reduced duration of symptoms. The same tendency was seen in the placebo group, with 59% reporting less intensity and 63% shorter duration of symptoms. However, a significance level of 5% was reached only in the case of duration of symptoms, which was reduced by 2.74 hours in the intervention group compared to 0.85 hours in the placebo group (p = 0.018).

CONCLUSIONS: Acupressure wristband might be an alternative therapy for morning sickness in early pregnancy, especially before pharmaceutical treatment is considered.

Effect of P6 acupressure on morning sickness

Lin MH, Yang YC, Wang KG
“Effect of P6 acupressure on morning sickness”
Department of Obs. and Gyn., Mackay Memorial Hospital, Taipei, Taiwan

PURPOSE: A prospective study was undertaken to value the effectiveness of pressure at P6 (Neiguan) acupuncture point in preventing morning sickness.

OBJECTIVES AND METHOD: Three groups of patients in early pregnancy recorded the severity and frequency of sickness over a period of 7 consecutive days following daily pressure at P6 point, pressure at other point of forearm and no treatment.

RESULTS: A significant difference between the severity of sickness in the control group and those having P6 acupressure and a significant difference between the controls and the Dummy acupressure series. Sickness was significantly less severe in patients practising P6 acupressure than in those using a Dummy point. No side effect occurred in patients practising p6 acupressure and while anticipation of benefit may offer a partial explanation for the findings, pressure at the Neiguan point appears to have a specific therapeutic effect.

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

Werntoft E, Dykes AK.
“Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study”
Department of Nursing, Unit of Caring Sciences, Lund University, Lund, Sweden.
J Reprod Med 2001; 46:835-839

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.

Gli effetti dell’acu-pressione sulla nausea ed il vomito in gravidanza: risultati di uno studio clinico prospettico randomizzato a doppio cieco

De Paoli F, Bossi C, Colombo F
“Gli effetti dell’acu-pressione sulla nausea ed il vomito in gravidanza: risultati di uno studio clinico prospettico randomizzato a doppio cieco”
Divisione Ostetrica e Ginecologica, Azienda Osped. Sant’Anna, Como, Italia
Estratto da terapie non Convenzionali nella Medicina della Riproduzione, Modena 23 Nov 2002

OBIETTIVO: confrontare l’effetto anti-emetico dell’acu-pressione nel punto P6 in un gruppo di giovani donne gravide.

TIPO DI STUDIO: Studio prospettico randomizzato a doppio cieco.

MATERIALI E METODI: Due differenti gruppi randomizzati di giovani gravide sono stati reclutati. Nel Gruppo A e stata esercitata acu-pressione nel punto p6 mentre nel gruppo B l’acu-pressione e stata esercitata in un punto, considerabile come “placebo”.

RISULTATI: nei 15 giorni di follow-up successivi al posizionamento del Sea-Band sono stati registrati i seguenti risultati: nel Gruppo A (attivo) il 74% delle gravide ha riferito una significativa [ p < 0.05] riduzione dlla frequenza di comparsa della nausea rispetto al solo 57% del gruppo placebo (Gruppo B). La scomparsa della nausea si e avuta rispettivamente nel 47% delle gravide del gruppo A, e nel 12% di quelle del Gruppo B [ p < 0.003]. Similmente e soprattutto nel Gruppo A, si e riscontrato un marcato decremento sia della frequenza (83% vs 38% nel Gruppo B,[ p < 0.001] sia della quantita (81% vs 34% nel Gruppo B, [ p < 0.001] di vomito mattutino.

CONCLUSIONI: si ritiene ragionevole concludere che l’acu-pressione di P6, mediante Sea-Band, possa considerarsi un adeguato trattamento della nausea e vomito mattutini nella gravida sia per la pressoché totale assenza di tossicità, sia per la sua facilità di utilizzo (correlata per altro ad un’elevata compliance da parte delle gravide).

Effect of a ginger extract on pregnancy-induced nausea

Design: Double-blind randomised placebo-controlled trial.
Setting: A tertiary metropolitan teaching hospital, March 1999–November 1999.
Participants: The participants included 120 women less than 20 weeks pregnant, who had experienced morning sickness daily for at least a week and had had no relief of symptoms through dietary changes.

Intervention: Random allocation of 125 mg ginger extract (EV.EXT35; equivalent to 1.5 g of dried ginger) or placebo given four times per day for 4 days.
Main outcome measures: Nausea, vomiting and retching as measured by the Rhodes Index of Nausea, Vomiting and Retching.

Results: The nausea experience score was significantly less for the ginger extract group relative to the placebo group after the first day of treatment and this difference was present for each treatment day. Retching was also reduced by the ginger extract although to a lesser extent. No significant effect was observed on vomiting. Follow-up of the pregnancies revealed normal ranges of birthweight, gestational age, Apgar scores and frequencies of congenital abnormalities when the study group infants were compared to the general population of infants born at the Royal Hospital for Women for the year 1999–2000.

Conclusion: Ginger can be considered as a useful treatment option for women suffering from morning sickness.
Key words: ginger, pregnancy, nausea, Zingiber officinale, morning sickness

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Ginger for Nausea and Vomiting in Pregnancy

Ginger for Nausea and Vomiting in Pregnancy: Randomized, Double-Masked, Placebo-Controlled Trial.
Objective: To determine the effectiveness of ginger for the treatment of nausea and vomiting of pregnancy.

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