Alternative Tx for hyperemesis gravidarum. (Review of the Data).

SARASOTA, FLA. -- Several alternative regimens appear to be beneficial for the treatment of hyperemesis gravidarum, Dr. Roger B. Newman said at a perinatal symposium sponsored by Symposia Medicus.

Alternative regimens can be difficult to study due to their highly individualized nature, problems with creating appropriate placebos, and difficulty measuring extent of nausea and vomiting, but some data suggest that certain regimens are as effective as antiemetic drugs. Many of these interventions are good alternatives to failed pharmacologic treatments; most are simple, inexpensive, and probably have a low risk of adverse effects or teratogenesis. Still, the lack of data leaves many unanswered questions about the safety and efficacy of some regimens, said Dr. Newman, professor and vice chairman of obstetrics and gynecology and director of maternal-fetal medicine at the Medical University of South Carolina in Charleston.

Among the regimens he discussed were:

* Acupressure. Placing pressure at the P6 point, also known as the Neiguan point, has been shown to reduce postoperative emesis, chemotherapy-associated emesis, and motion sickness, as well as hyperemesis gravidarum. P6 is found on the volar surface of the forearm, three finger breadths above the wrist.

In one controlled study, manual acupressure over the P6 area was compared with acupressure over a "dummy" point over a 4-day period. Of the 350 patients studied, severe morning sickness was reported after 4 days by 24% in the P6 acupressure group, by 37% in the dummy acupressure group, and by 56% in the control group.

While some studies have found no effect with acupressure, others using acupressure wristbands at the P6 point resulted in relief in up to 75% of patients, Dr. Newman said. ...