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

Nor Azila Mohd Nafiah, Wei Keong Chieng, Ani Amelia Zainuddin, Kah Teik Chew, Aida Kalok, Muhammad Azrai Abu, Beng Kwang Ng, Nor Azlin Mohamed Ismail, Abdul Ghani Nur Azurah, Nor Azila Mohd Nafiah, Wei Keong Chieng, Ani Amelia Zainuddin, Kah Teik Chew, Aida Kalok, Muhammad Azrai Abu, Beng Kwang Ng, Nor Azlin Mohamed Ismail, Abdul Ghani Nur Azurah

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).

Keywords: acupressure wristband; antiemetics; efficacy; morning sickness; normal intrauterine pregnancy; pregnancy complications; urine ketone.

Conflict of interest statement

The authors declare no conflict of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
(A): The location of P6 acupressure point. The P6 point is indicated by pink dot. Red line represents the distance of 2 inches, which is proximal to the distal wrist crease. The tendons of flexor carpi radialis and tendon of palmaris longus are as labelled. (B) A schematic diagram showing the location of P6 point.
Figure 2
Figure 2
Enrollment and randomization flow chart.

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