Abstract
BackgroundNausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) have a significant impact on quality of life. Medication to relieve symptoms of NVP and HG are available but pregnant women and their caregivers have been concerned about the teratogenic effect, side effects and poor efficacy. The aim of this review was to investigate if there is any clinical evidence for the efficacy of acustimulation in the treatment of NVP or HG.MethodsA systematic review of randomized controlled trials (RCTs), including both English and Chinese databases was conducted to assess the efficacy of various techniques of acustimulation for NVP and HG. The methodological quality of the studies was assessed using the Cochrane’s risks of bias tool. Revised STRICTA (2010) criteria were used to appraise acustimulation procedures. Pooled relative risks (RRp) and standard mean deviations (SMD) with 95 % confidence intervals (CI) were calculated from the data provided by the investigators of the original trials.ResultsTwenty-nine trials including 3519 patients met the inclusion criteria. Twenty trials could be included in statistical pooling. The overall effect of different acustimulation techniques shows a significant reduction for the combined outcome for NVP or HG in pregnancy as a dichotomous variable (RRp 1.73, 95 % CI 1.43 to 2.08). Studies with continuous outcome measures for nausea, vomiting and the combined outcome did not show any evidence for relieving symptoms of NVP and HG (SMD −0.12, 95 % CI −0.35 to 0.12).ConclusionsAlthough there is some evidence for an effect of acustimulation on nausea and vomiting or hyperemesis in pregnancy, results are not conclusive. Future clinical trials with a rigorous design and large sample sizes should be conducted to evaluate the efficacy and safety of these interventions for NVP and HG.
Highlights
Nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) have a significant impact on quality of life
Conclusions: there is some evidence for an effect of acustimulation on nausea and vomiting or hyperemesis in pregnancy, results are not conclusive
Search strategies A comprehensive electronic search was performed in the following databases from their inception to August 2014: Cochrane Database of Systematic Reviews, The Cochrane Central Register of Controlled Trials (CENTRAL), Medline (National Library of Medicine), Embase and Science Direct (Elsevier), Latin American and Caribbean Health Sciences (LILACS), Allied and Complementary Medicine Database (AMED), Database of abstracts of reviews of effects (DARE), Trip Database, Web of science core collection database, Cumulative Index to Nursing and Allied Health Literature (Cinahl), Physiotherapy Evidence Database (Pedro), BJI Best Practices in OvidSP, BMJ Clinical evidence and National Institute for Health and Care Excellence (NICE)
Summary
Nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) have a significant impact on quality of life. Medication to relieve symptoms of NVP and HG are available but pregnant women and their caregivers have been concerned about the teratogenic effect, side effects and poor efficacy. Nausea and vomiting in pregnancy (NVP) is commonly experienced in early pregnancy, most frequently between 6 and 12 weeks. NVP can continue till 20 weeks, and persist after this time for up to 20 % of women [1]. NVP has a significant impact on quality of life for pregnant women and their families [4]. It causes discomfort, disability and suffering and results in absence from work and social activities [5]. Almost 50 % of women reported that NVP negatively affected
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