Recent research highlights the efficacy of acupuncture for nausea and vomiting treatment during pregnancy (NVP), addressing the significant challenges associated with its management. This systematic review and meta-analysis evaluated data from 24 randomized controlled trials (RCTs) involving 2,390 pregnant women, providing critical insights into acupuncture’s therapeutic potential and clinical applications. This condition is also referred to as morning sickness and, in severe cases, hyperemesis.

The analysis revealed that acupuncture, particularly when combined with conventional Western medicine (WM), demonstrated significant reductions in Pregnancy-Unique Quantification of Emesis (PUQE) scores, improved ketonuria, shortened hospital stays, and enhanced quality of life as measured by the NVP Quality of Life Questionnaire (NVPQOL). Notably, acupuncture was found to reduce ineffective treatment rates more effectively than WM alone. [1]

No significant differences in severe adverse events (SAEs) were observed between acupuncture, WM, and sham acupuncture, emphasizing acupuncture’s safety profile. Minor adverse events, such as mild pain and itching at acupuncture sites, were reported in a few studies but resolved spontaneously.

The systematic review underscores the importance of precise acupoint selection and consistent procedural techniques. The most frequently utilized acupoints were:

• PC6 (Neiguan): Located on the pericardium meridian, 2 cun above the transverse crease of the wrist, between the tendons of the palmaris longus and flexor carpi radialis. This point was used in 19 of the studies and is associated with modulating stomach qi and calming the mind.
• ST36 (Zusanli): Found on the stomach channel, 3 cun below the lower border of the patella and 1 finger-breadth lateral to the anterior crest of the tibia. This point regulates gastrointestinal motility and tonifies spleen and stomach qi.
• CV12 (Zhongwan): Located on the conception vessel, 4 cun above the umbilicus. It harmonizes the stomach and regulates qi.
• Other points, including ST40 (Fenglong) and SP4 (Gongsun), were also occasionally incorporated.

The most commonly used needles were sterile, single-use filiform needles, with a gauge of 0.25 mm and lengths ranging from 25 to 40 mm. Needles were typically inserted to achieve the deqi sensation. Retention times varied but often lasted 30 minutes per session, with treatment frequencies ranging from daily to twice weekly, depending on the severity of symptoms and patient tolerance.

Acupuncture’s efficacy is attributed to its ability to:

• Modulate gastric motility through vasovagal and sympathetic reflexes.
• Adjust neurotransmitter levels, reducing vomitogenic activity in the central nervous system.
• Enhance parasympathetic activity while suppressing sympathetic overdrive.

Patients receiving acupuncture plus WM showed significant improvements in ketonuria clearance rates (risk ratio [RR]: 1.32, p = 0.0002) and reductions in hospital length of stay (mean difference [MD]: -2.89 days, p < 0.00001). PUQE scores were also significantly lower, demonstrating robust symptom control.

The research made notes for licensed acupuncturists to include:

• Establishing a consistent treatment schedule (e.g., daily sessions for 1-2 weeks for acute symptoms).
• Ensuring proper needle placement and stimulation to achieve therapeutic effects.
• Integrating acupuncture with WM for synergistic benefits.

This comprehensive review highlights acupuncture’s role as an effective and safe option for managing NVP, with tangible benefits in symptom reduction and quality of life improvements. While the evidence supports its use, further high-quality RCTs are necessary to refine treatment protocols and enhance the understanding of acupuncture’s mechanisms in pregnancy-related nausea and vomiting.

Apple iTunes Podcast:
https://podcasts.apple.com/us/podcast/acupuncture-and-herbs/id442141931

Spotify Podcast:
https://open.spotify.com/show/685ilKlbo1HyYd8PWgvVgA?si=772776c7aeaf42bb

Acupoint Highlight

The main acupuncture point for nausea and vomiting relief is PC6 (Neiguan), translated as inner pass. According to traditional Chinese medicine principles, PC6 unbinds the chest, regulates qi, regulates the heart, calms the spirit, harmonizes the stomach, alleviates nausea and vomiting, clears heat, and opens the yin linking vessel. Common indications for use include insomnia, nausea, vomiting, palpitations, local pain, hiccups, digestive disturbances, and headaches. This point is so effective that an electrostimulator device worn at this acupoint called reliefband is cleared by the FDA for alleviating nausea and vomiting due to car sickness and sea sickness.

Source:

1. Jin B, Han Y, Jiang Y, et al. Acupuncture for nausea and vomiting during pregnancy: A systematic review and meta-analysis. Complementary Therapies in Medicine. 2024;85:103079.