Paper
Saturday, July 16, 2005
This presentation is part of : Meta-Analyses of Acupressure Studies: Effects on Nausea- and Vomiting-Related Symptoms in Three Patient Populations
Meta-analysis of Acupressure Studies: Effects on Nausea and Vomiting related Symptoms in Pregnant Women
Rebecca J. Helmreich, MSN, RN, Schhol of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA, Shyang-Yun P. K. Shiao, PhD, RN, FAAN, School of Nursing, Univesity of Texas Health Science Center at Houston, Houston, TX, USA, Kara A. Helfenbein, BSN, RN, Schhol of Nursing, Univesity of Texas Health Science Center at Houston, Houston, TX, USA, and Linda S. Dune, PhD, RN, CCRN, CEN, Acute Care Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA.

About 50% to 90% of pregnant women have symptoms of morning sickness including nausea, dry retching, and vomiting (NVS), during the early stage of pregnancy. Reduced gastric motility and the stimulation of chemoreceptor trigger zone with increased hormone levels are major causes of NVS. Increased heart rate and respiratory rate with increased metabolic demands during pregnancy further decrease parasympathetic capacity to organize the neurological responses to cause NVS. With increased concerns for complications of drugs to fetus and the stimulations of chemoreceptor zone, acupressure is more feasible than medications for pregnant women.

Previous reviews on NVS during pregnancy included all complementary and alternative therapies and indicated significant effects with acupressure, vitamine B6, and ginger; and of 6 trials reviewed, acupuncture and acupressure effects were combined. Thus, systematic reviews and meta-analyses of acupressure studies were conducted for pregnant women for the current best evidence. Fourteen studies were located for pregnant women, including 11 acupressure studies and 3 acupuncture studies; of which wrist acuband was used in 8 studies; manual finger pressure in 2 studies, and transcutaneous electric nerve stimulator in 1 study. The results were coded and evaluated by two raters to reach 100% agreement.

Pericardium 6 point was used in all studies without side effects. All studies except two indicated significant NVS relief with acupressure therapy, and these two studies without significant effects were poor quality papers for design, data collection, and scholarly considerations. The pooled relative risk reduction for NVS was 0.51 (n = 879, P < 0.0001) comparing acupressure to placebo effects. Nausea symptom was reduced in 6 studies, and NVS in 3 studies. Use of unilateral acuband was as effective as bilateral acubands. Additional acupoints used in acupuncture studies included ST34, ST36, ST44, SP4, and REN12. These acupoints and the studies will be discussed during the presentation.