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Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. [1] Despite the name, nausea or vomiting can occur at any time during the day. [2] Typically the symptoms occur between the 4th and 16th weeks of pregnancy. [2]
Evidence for acupressure is poor. [3] While vomiting in pregnancy has been described as early as 2,000 BCE, the first clear medical description of HG was in 1852, by Paul Antoine Dubois. [12] HG is estimated to affect 0.3–2.0% of pregnant women, although some sources say the figure can be as high as 3%.
The best-studied alternative therapy is perhaps the use of acupressure for pregnancy-related nausea and vomiting. [citation needed] Wristbands with acupressure buttons are commercially available. An implanted device with attached electrodes into the gastric wall can be an option for patients with refractory nausea and vomiting. [9]
The vomiting center of the brain refers to the groups of loosely organized neurons in the medulla that include the CTZ within the area postrema and the nucleus tractus solitarii. [2] One of the ways the chemoreceptor trigger zone implements its effects on the vomiting center is by activation of the opioid mu receptors and delta receptors. [6]
Antihistamines may be prescribed in early pregnancy for the treatment of nausea and vomiting along with symptoms of asthma and allergies. [54] First generation antihistamines include diphenhydramine (Benadryl), chlorpheniramine (Diabetic Tussin), hydroxyzine (Atarax), and doxepin (Sinequan). [55]
Preliminary clinical data suggests ginger may be effective for treatment of nausea and/or vomiting in a number of settings. [20] [21] [22] Emetrol is also claimed to be an effective antiemetic. Propofol is given intravenously. It has been used in an acute care setting in hospital as a rescue therapy for emesis. [23]
In cases of gastroenteritis, serotonin antagonists such as ondansetron were found to suppress nausea and vomiting, as well as reduce the need for IV fluid resuscitation. [22] The combination of pyridoxine and doxylamine is the first line treatment for pregnancy-related nausea and vomiting. [22]
The two general types of alternative pressure therapy are sham acupressure and the use of the P6 point. A 2015 study found no significant difference between the use of either therapy in the treatment or prevention of PONV. In a review of 59 studies, both therapies significantly affected the nausea aspect, but had no significant effect on vomiting.