WITHDRAWN: Interventions for nausea and vomiting in early pregnancy.
Summary of "WITHDRAWN: Interventions for nausea and vomiting in early pregnancy."
BACKGROUND:
Nausea and vomiting are the most common symptoms experienced in early pregnancy, with nausea affecting between 70 and 85% of women. About half of pregnant women experience vomiting.
OBJECTIVES:
To assess the effects of different methods of treating nausea and vomiting in early pregnancy. SEARCH
STRATEGY:
We searched the Cochrane Pregnancy and Childbirth Group trials register (December 2002) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4, 2002). SELECTION
CRITERIA:
Randomised trials of any treatment for nausea and/or vomiting in early pregnancy. DATA COLLECTION AND
ANALYSIS:
Two reviewers assessed the trial quality and extracted the data independently. MAIN
RESULTS:
Twenty-eight trials met the inclusion criteria. For milder degrees of nausea and vomiting, 21 trials were included. These trials were of variable quality. Nausea treatments were: different antihistamine medications, vitamin B6 (pyridoxine), the combination tablet Debendox (Bendectin), P6 acupressure and ginger. For hyperemesis gravidarum, seven trials were identified testing treatments with oral ginger root extract, oral or injected corticosteroids or injected adrenocorticotropic hormone (ACTH), intravenous diazepam and acupuncture. Based on 12 trials, there was an overall reduction in nausea from anti-emetic medication (odds ratio 0.16, 95% confidence interval 0.08 to 0.33). AUTHORS'
CONCLUSIONS:
Anti-emetic medication appears to reduce the frequency of nausea in early pregnancy. There is some evidence of adverse effects, but there is very little information on effects on fetal outcomes from randomised controlled trials. Of newer treatments, pyridoxine (vitamin B6) appears to be more effective in reducing the severity of nausea. The results from trials of P6 acupressure are equivocal. No trials of treatments for hyperemesis gravidarum show any evidence of benefit. Evidence from observational studies suggests no evidence of teratogenicity from any of these treatments.
Affiliation
Division of Primary Health Care, University of Bristol, Cotham House, Cotham Hill, Bristol, UK, BS6 6JL.
Journal Details
This article was published in the following journal.
Name: Cochrane database of systematic reviews (Online)
ISSN: 1469-493X
Pages: CD000145
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20824826
- DOI: http://dx.doi.org/10.1002/14651858.CD000145.pub2
Medical and Biotech [MESH] Definitions
Morning Sickness
Symptoms of NAUSEA and VOMITING in pregnant women that usually occur in the morning during the first 2 to 3 months of PREGNANCY. Severe persistent vomiting during pregnancy is called HYPEREMESIS GRAVIDARUM.
Hyperemesis Gravidarum
Intractable VOMITING that develops in early PREGNANCY and persists. This can lead to DEHYDRATION and WEIGHT LOSS.
Nausea
An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.
Pregnancy Complications
Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases.
Dimenhydrinate
A drug combination that contains DIPHENHYDRAMINE and THEOPHYLLINE. It is used for treating vertigo, motion sickness, and nausea associated with pregnancy. It is not effective in the treatment of nausea associated with cancer chemotherapy.
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