Which potential harms and benefits of using ginger in the management of nausea and vomiting of pregnancy should be addressed? a consensual study among pregnant women and gynecologists

Ramzi Shawahna,Assim Taha

doi:10.1186/s12906-017-1717-0

Ramzi Shawahna, Assim Taha

Open Access

https://doi.org/10.1186/s12906-017-1717-0

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Abstract

BackgroundNausea and vomiting of pregnancy (NVP) affect approximately 80–90% of the pregnant women. Ginger (Zingiber officinale Roscoe) is the most widely used herbal therapy in the management of NVP. Like conventional therapies, herbal therapies have potential harms and benefits that patients need to be informed about in order to develop their therapy preferences. The aim of this study was to achieve consensus among women who suffered NVP and physicians often consulted by pregnant women on a core list of potential harms and benefits of using ginger to manage NVP to be addressed during clinical consultations.MethodsIn this study, the Delphi technique was used to achieve consensus on a core list of important harms and benefits of using ginger in the management of NVP to be addressed during the clinical consultation. A Delphi process was followed in two panels in parallel sessions. One panel was composed of 50 gynecologists and other physicians who are often consulted by pregnant women suffering NVP and the other panel was composed of 50 women who suffered NVP.ResultsConsensus was achieved on 21 (75%) of the 28 potential harms presented to the panelists. Panelists agreed that potential harms of the anticoagulant effects of ginger, risk with other co-morbidities, and risk of potential allergic reactions are important to address during the clinical consultation. Of the 14 potential benefits presented to the panelists in both panels, consensus was achieved on 13 (92.9%). Partial consensus on 7 potential harms and 1 potential benefit was achieved in both panels.ConclusionsAddressing important potential harms and benefits of using ginger for the management of NVP during the clinical consultations is important in promoting congruence and reducing patient dissatisfaction in clinical practice. Consensus was achieved on a core list of important harms and benefits of using ginger for the management of NVP to be addressed during the clinical consultations by a panel of women and a panel of physicians. Further studies are still needed to investigate what is being addressed during clinical consultations.

Highlights

Nausea and vomiting of pregnancy (NVP) affect approximately 80–90% of the pregnant women
The aim of this study was to achieve consensus among women who suffered NVP, gynecologists and other physicians who are frequently consulted by pregnant women for their NVP on a core list of potential harms and benefits of using ginger to manage NVP that should be addressed during clinical consultations on which a decision to use ginger is taken
Potential harms and benefits of using ginger in NVP Prior to the iterative Delphi rounds, we interviewed 8 key contact gynecologists who frequently recommend pregnant women with NVP to use ginger and 8 women with more than 5 prior pregnancies who were recommended to use ginger to reduce the symptoms of their NVP

Summary

Introduction

Nausea and vomiting of pregnancy (NVP) affect approximately 80–90% of the pregnant women. Nausea and vomiting of pregnancy (NVP) rank high among the most common complaints during the early weeks of pregnancy [1] In clinical practice, both patients and physicians are reluctant to use medications in pregnancy, especially in the first trimesters due to the possibility of harming the unborn fetus [2]. Many pregnant women might present a severer and more persistent form of vomiting known as hyperemesis gravidarum which can lead to dehydration, electrolyte disturbances, damage the liver, damage of the developing fetus, and in extreme cases, the death of the mother and her fetus. This condition occurs in nearly 2% of pregnancies [1, 2]

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