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Review
. 2015 Sep 8;2015(9):CD007575.
doi: 10.1002/14651858.CD007575.pub4.

Interventions for nausea and vomiting in early pregnancy

Anne Matthews  1 , David M Haas, Dónal P O'Mathúna, Therese Dowswell
Affiliations
Review

Interventions for nausea and vomiting in early pregnancy

Anne Matthews et al. Cochrane Database Syst Rev. .

Abstract

Background: Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical, social and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy last published in 2014.

Objectives: To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks' gestation.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, the Cochrane Complementary Medicine Field's Trials Register (19 January 2015) and reference lists of retrieved studies.

Selection criteria: All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum, which are covered by another Cochrane review. We also excluded quasi-randomised trials and trials using a cross-over design.

Data collection and analysis: Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials.

Main results: Forty-one trials involving 5449 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, chamomile, lemon oil, mint oil, vitamin B6 and several antiemetic drugs. There were no included studies of dietary and other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent, though three recent studies support ginger over placebo. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, Doxylamine-pyridoxoine and other anti-emetic drugs to relieve mild or moderate nausea and vomiting. There was little information on maternal and fetal adverse outcomes and on psychological, social or economic outcomes.We were unable to pool findings from studies for most outcomes due to heterogeneity in study participants, interventions, comparison groups, and outcomes measured or reported. The methodological quality of the included studies was mixed. Risk of bias was low related to performance bias, detection bias and attrition bias for most studies. Selection bias risk was unclear for many studies and almost half of the studies did not fully or clearly report all pre-specified outcomes.

Authors' conclusions: Given the high prevalence of nausea and vomiting in early pregnancy, women and health professionals need clear guidance about effective and safe interventions, based on systematically reviewed evidence. There is a lack of high-quality evidence to support any particular intervention. This is not the same as saying that the interventions studied are ineffective, but that there is insufficient strong evidence for any one intervention. The difficulties in interpreting and pooling the results of the studies included in this review highlight the need for specific, consistent and clearly justified outcomes and approaches to measurement in research studies.

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Conflict of interest statement

No declarations of interest.

Figures

1
1
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
2
2
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 1 Severity of nausea after treatment (of 4 days) using a 10 cm VAS.
1.2
1.2. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 2 No improvement in intensity of symptoms (while using wristbands) reported.
1.3
1.3. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 3 Mean nausea score after day 3 using VAS.
1.4
1.4. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 4 Mean nausea score days 1‐3 (average).
1.5
1.5. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 5 Mean total scores (Rhodes Index) days 1‐3 (average).
1.6
1.6. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 6 Total Rhodes Index score on the 3rd day of intervention.
1.7
1.7. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 7 Severity of vomiting after treatment (of 4 days) as number of vomiting episodes.
1.8
1.8. Analysis
Comparison 1 P6 Acupressure versus placebo, Outcome 8 Mean emesis scores days 1‐3 (average).
2.1
2.1. Analysis
Comparison 2 P6 Acupressure versus vitamin B6, Outcome 1 Nausea scores on day 3.
2.2
2.2. Analysis
Comparison 2 P6 Acupressure versus vitamin B6, Outcome 2 Poor symptom relief/amount of rescue medication (number of tablets).
3.1
3.1. Analysis
Comparison 3 Auricular acupressure versus placebo, Outcome 1 Nausea/vomiting score (combined Rhodes Index score) on day 6 (3 days after treatment started).
3.2
3.2. Analysis
Comparison 3 Auricular acupressure versus placebo, Outcome 2 Number of anti‐emetic drugs used on day 6 (3 days after treatment started).
4.1
4.1. Analysis
Comparison 4 Acustimulation therapy at P6 point versus placebo, Outcome 1 Weight gain (in lbs) over 3 week period.
4.2
4.2. Analysis
Comparison 4 Acustimulation therapy at P6 point versus placebo, Outcome 2 Dehydration: occurrences reported.
4.3
4.3. Analysis
Comparison 4 Acustimulation therapy at P6 point versus placebo, Outcome 3 Ketonuria at the end of the trial.
5.1
5.1. Analysis
Comparison 5 Traditional acupuncture versus placebo, Outcome 1 Mean nausea score on day 7.
5.2
5.2. Analysis
Comparison 5 Traditional acupuncture versus placebo, Outcome 2 Mean dry retching score on day 7.
5.3
5.3. Analysis
Comparison 5 Traditional acupuncture versus placebo, Outcome 3 Mean vomiting score on day 7.
6.1
6.1. Analysis
Comparison 6 P6 Acupuncture versus placebo, Outcome 1 Mean nausea score on day 7.
6.2
6.2. Analysis
Comparison 6 P6 Acupuncture versus placebo, Outcome 2 Mean dry retching score on day 7.
6.3
6.3. Analysis
Comparison 6 P6 Acupuncture versus placebo, Outcome 3 Mean vomiting score on day 7.
7.1
7.1. Analysis
Comparison 7 Traditional acupuncture versus P6 acupuncture, Outcome 1 Mean nausea score on day 7.
7.2
7.2. Analysis
Comparison 7 Traditional acupuncture versus P6 acupuncture, Outcome 2 Mean dry retching score on day 7.
7.3
7.3. Analysis
Comparison 7 Traditional acupuncture versus P6 acupuncture, Outcome 3 Mean vomiting score on day 7.
8.1
8.1. Analysis
Comparison 8 Ginger versus placebo, Outcome 1 Mean nausea score (using Rhodes Index) on day 3.
8.2
8.2. Analysis
Comparison 8 Ginger versus placebo, Outcome 2 Total Rhodes Index score on day 3.
8.3
8.3. Analysis
Comparison 8 Ginger versus placebo, Outcome 3 Total Rhodes Index score on the 3rd day of intervention.
8.4
8.4. Analysis
Comparison 8 Ginger versus placebo, Outcome 4 Total Rhodes Index score after 1 week treatment.
8.5
8.5. Analysis
Comparison 8 Ginger versus placebo, Outcome 5 Little improvement in nausea.
8.6
8.6. Analysis
Comparison 8 Ginger versus placebo, Outcome 6 Improvement in nausea (mean change score) over 4 days of treatment: women available to follow up.
8.7
8.7. Analysis
Comparison 8 Ginger versus placebo, Outcome 7 Improvement in nausea (mean change score) over 4 days of treatment: ITT analysis.
8.8
8.8. Analysis
Comparison 8 Ginger versus placebo, Outcome 8 Improvement in nausea intensity after treatment (day 5).
8.9
8.9. Analysis
Comparison 8 Ginger versus placebo, Outcome 9 Average change in nausea score for days 1‐4, using 10cm VAS.
8.10
8.10. Analysis
Comparison 8 Ginger versus placebo, Outcome 10 Symptoms improved (better or much better versus same).
8.11
8.11. Analysis
Comparison 8 Ginger versus placebo, Outcome 11 Mean vomiting severity (using Rhodes Index) on day 3.
8.12
8.12. Analysis
Comparison 8 Ginger versus placebo, Outcome 12 Number of women continuing vomiting at day 6.
8.13
8.13. Analysis
Comparison 8 Ginger versus placebo, Outcome 13 Spontaneous abortion.
8.14
8.14. Analysis
Comparison 8 Ginger versus placebo, Outcome 14 Caesarean delivery.
9.1
9.1. Analysis
Comparison 9 Ginger versus P6 Acupressure, Outcome 1 Total Rhodes Index score on the 3rd day of intervention.
10.1
10.1. Analysis
Comparison 10 Ginger versus chamomile, Outcome 1 Rhodes Index score after 1 week treatment.
11.1
11.1. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 1 Nausea vomiting score day 3.
11.2
11.2. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 2 Post‐treatment number of vomiting episodes: day 3.
11.3
11.3. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 3 No improvement in symptoms.
11.4
11.4. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 4 Spontaneous abortion.
11.5
11.5. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 5 Stillbirth.
11.6
11.6. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 6 Congenital abnormality.
11.7
11.7. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 7 Antepartum haemorrhage/abruption, placenta praevia.
11.8
11.8. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 8 Pregnancy‐induced hypertension.
11.9
11.9. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 9 Pre‐eclampisa.
11.10
11.10. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 10 Preterm birth.
11.11
11.11. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 11 Arrhythmia.
11.12
11.12. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 12 Headache.
11.13
11.13. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 13 Heartburn.
11.14
11.14. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 14 Sedation or drowsiness.
11.15
11.15. Analysis
Comparison 11 Ginger versus vitamin B6, Outcome 15 Caesarean delivery.
12.1
12.1. Analysis
Comparison 12 Ginger versus metoclopramide, Outcome 1 Mean score for nausea (using Rhodes Index) on day 3.
12.2
12.2. Analysis
Comparison 12 Ginger versus metoclopramide, Outcome 2 Mean score for vomiting (using Rhodes Index) on day 3.
12.3
12.3. Analysis
Comparison 12 Ginger versus metoclopramide, Outcome 3 Rhodes Index score on day 3.
13.1
13.1. Analysis
Comparison 13 Ginger versus dimenhydrinate, Outcome 1 Drowsiness.
13.2
13.2. Analysis
Comparison 13 Ginger versus dimenhydrinate, Outcome 2 Heartburn.
14.1
14.1. Analysis
Comparison 14 Lemon oil versus placebo, Outcome 1 Mean PUQE score on day 3 of intervention.
14.2
14.2. Analysis
Comparison 14 Lemon oil versus placebo, Outcome 2 Mean difference of total PUQE scores from baseline to day 3 of intervention.
14.3
14.3. Analysis
Comparison 14 Lemon oil versus placebo, Outcome 3 Satisfaction with the given treatment.
15.1
15.1. Analysis
Comparison 15 Mint oil versus placebo, Outcome 1 Severity of nausea on day 4.
15.2
15.2. Analysis
Comparison 15 Mint oil versus placebo, Outcome 2 Vomiting intensity on day 4.
16.1
16.1. Analysis
Comparison 16 Chamomile versus placebo, Outcome 1 Rhodes Index score after 1 week treatment.
17.1
17.1. Analysis
Comparison 17 Vitamin B6 versus placebo, Outcome 1 Mean reduction in nausea score after 3 days.
17.2
17.2. Analysis
Comparison 17 Vitamin B6 versus placebo, Outcome 2 Number of patients with emesis post‐therapy.
18.1
18.1. Analysis
Comparison 18 Vitamin B6 (high dose) versus Vitamin B6 (low dose), Outcome 1 Mean change in PUQE score from baseline to 2 weeks.
19.1
19.1. Analysis
Comparison 19 Vitamin B6 versus dimenhydrinate, Outcome 1 Nausea and vomiting score after 3 days of treatment using Rhodes Index.
19.2
19.2. Analysis
Comparison 19 Vitamin B6 versus dimenhydrinate, Outcome 2 Drowsiness.
20.1
20.1. Analysis
Comparison 20 Hydroxyzine versus placebo, Outcome 1 No relief from nausea.
20.2
20.2. Analysis
Comparison 20 Hydroxyzine versus placebo, Outcome 2 Spontaneous abortion (1st or 2nd trimester).
20.3
20.3. Analysis
Comparison 20 Hydroxyzine versus placebo, Outcome 3 Perinatal mortality.
21.1
21.1. Analysis
Comparison 21 Dicyclomine/ doxylamine/ pyridoxine versus placebo, Outcome 1 No improvement of symptoms.
22.1
22.1. Analysis
Comparison 22 Doxylamine and pyridoxine versus placebo, Outcome 1 Mean difference in nausea/vomiting/retching (PUQE score) baseline to day 15.
22.2
22.2. Analysis
Comparison 22 Doxylamine and pyridoxine versus placebo, Outcome 2 Requests for compassionate use of drug after day 14.
22.3
22.3. Analysis
Comparison 22 Doxylamine and pyridoxine versus placebo, Outcome 3 Headache.
22.4
22.4. Analysis
Comparison 22 Doxylamine and pyridoxine versus placebo, Outcome 4 Somnolence.
22.5
22.5. Analysis
Comparison 22 Doxylamine and pyridoxine versus placebo, Outcome 5 Difference in global assessment of well‐being from baseline to day 15.
22.6
22.6. Analysis
Comparison 22 Doxylamine and pyridoxine versus placebo, Outcome 6 Time loss from employment in days.
23.1
23.1. Analysis
Comparison 23 Thiethylperazine versus placebo, Outcome 1 Poor relief from symptoms.
24.1
24.1. Analysis
Comparison 24 Fluphenazine‐pyridoxine versus placebo, Outcome 1 Poor response to treatment.
25.1
25.1. Analysis
Comparison 25 Metoclopramide versus placebo, Outcome 1 Mean score for nausea (using Rhodes Index) on day 3.
25.2
25.2. Analysis
Comparison 25 Metoclopramide versus placebo, Outcome 2 Mean score for vomiting (using Rhodes Index) on day 3.
26.1
26.1. Analysis
Comparison 26 Ondansetron versus metoclopramide, Outcome 1 Average number of nausea episodes on day 3 after treatment..
26.2
26.2. Analysis
Comparison 26 Ondansetron versus metoclopramide, Outcome 2 Average number of vomiting episodes on day 3 after treatment..
27.1
27.1. Analysis
Comparison 27 Ondansetron versus pyridoxine‐doxylamine, Outcome 1 Clinically significant (≥25mm on VAS) reduction in nausea after 5 days of treatment.
27.2
27.2. Analysis
Comparison 27 Ondansetron versus pyridoxine‐doxylamine, Outcome 2 Sedation.
27.3
27.3. Analysis
Comparison 27 Ondansetron versus pyridoxine‐doxylamine, Outcome 3 Constipation.
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Smith 2004 {published data only}
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    1. Smith CA, Hotham N, MacMillan V, Crowther CA. Comparison of ginger and vitamin B6 for treating nausea and vomiting in early pregnancy: a randomised controlled trial. Perinatal Society of Australia and New Zealand 7th Annual Congress; 2003 March 9‐12; Tasmania, Australia. 2003:P47.
Sripramote 2003 {published data only}
    1. Sripramote M, Lekhyananda N. A randomized comparison of ginger and vitamin b6 in the treatment of nausea and vomiting in pregnancy. Journal of the Medical Association of Thailand 2003;86:846‐53. - PubMed
Vutyavanich 1995 {published data only}
    1. Vutyavanich T, Wongtra‐ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double‐blind, placebo‐controlled trial. American Journal of Obstetrics and Gynecology 1995;173(3 Pt 1):881‐4. - PubMed
Vutyavanich 2001 {published data only}
    1. Kraisarin T, Vutyavanich T. The effectiveness of ginger for the treatment of nausea and vomiting of pregnancy. Thai Journal of Obstetrics and Gynaecology 2000;12(4):340.
    1. Vutyavanich T, Kraisarin T, Ruangsri RA. Ginger for nausea and vomiting in pregnancy: randomized double masked, placebo controlled trial. Obstetrics & Gynecology 2001;97:577‐88. - PubMed
Werntoft 2001 {published data only}
    1. Werntoft E, Dykes AK. Effect of acupressure on nausea and vomiting during pregnancy. Journal of Reproductive Medicine 2001;46(9):835‐9. - PubMed
Wibowo 2012 {published data only}
    1. Wibowo N. B6 treatment for nausea and vomiting in pregnancy. ClinicalTrials.gov (http://clinicaltrials.gov/) [accessed 4 January 2009] 2009.
    1. Wibowo N, Purwosunu Y, Sekizawa A, Farina A, Tambunan V, Bardosono S. Vitamin B(6) supplementation in pregnant women with nausea and vomiting. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics 2012;116(3):206‐10. - PubMed
Willetts 2003 {published data only}
    1. Willetts KE, Ekangaki A, Eden JA. Effect of a ginger extract on pregnancy‐induced nausea: a randomised controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology 2003;43:139‐44. - PubMed
Yavari 2014 {published data only}
    1. Safajou F. The effect of lemon inhaler aromatherapy on nausea and vomiting of pregnancy: a randomised controlled trial. IRCT: Iranian Register of Clinical Trials (www.irct.ir) [accessed 30 April 2010] 2010.
    1. Yavari Kia PY, Safajou F, Shahnazi M, Nazemiyeh H. The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: a double‐blinded, randomized, controlled clinical trial. Iranian Red Crescent Medical Journal 2014;16(3):e14360. - PMC - PubMed
    1. Yavari Kia PY, Safajou F, Shahnazi M, Nazemiyeh H. The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: double‐blind randomised controlled clinical trial. Author's unpublished copy of article for submission to a journal 2013. - PMC - PubMed

References to studies excluded from this review

Anjum 2002 {published data only}
    1. Anjum N, Rizvi MIS, Ayub Z, Baig MA, Hameed A. Control of early morning sickness of pregnancy by acupressure technique. Annals of Abbasi Shaheed Hospital & Karachi Medical & Dental College 2002;7(2):369‐73.
Baum 1963 {published data only}
    1. Baum G, Boxer EI, Davidson JH, Lawrence N, Lewis JBR, Morgan DJR, et al. Meclozine and pyridoxine in pregnancy sickness. Practitioner 1963;190:251‐3.
Bayreuther 1994 {published data only}
    1. Bayreuther J, Lewith GT, Pickering R. A double‐blind cross‐over study to evaluate the effectiveness of acupressure at pericardium 6 (P6) in the treatment of early morning sickness (EMS). Complementary Therapies in Medicine 1994;2:70‐6.
Can Gurkan 2008 {published data only}
    1. Can Gurkan O, Arslan H. Effect of acupressure on nausea and vomiting during pregnancy. Complementary Therapies in Clinical Practice 2008;14(1):46‐52. - PubMed
Cartwright 1951 {published data only}
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Conklin 1958 {published data only}
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De Aloysio 1992 {published data only}
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Diggory 1962 {published data only}
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Dundee 1988 {published data only}
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Evans 1993 {published data only}
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Ferruti 1982 {published data only}
    1. Ferruti MM, Speranza R. Use of the combination of adrenal cortex extract, pyridoxal‐5‐phosphate, cyanocobalamin and ascorbic acid in the treatment of hypocorticism in pregnancy [Italian] [Sulla utilita dell'associazione di estratto corticosurrenale, piridossal‐5‐fosfato, cianocobalamina e acido ascorbico nel trattamento degli stati di ipocorticalismo in gravidanza.]. Minerva Ginecologica 1982;34:619‐23. - PubMed
Fitzgerald 1955 {published data only}
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Heazell 2006 {published data only}
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Hyde 1989 {published data only}
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Kadan 2009 {published data only}
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King 1955 {published data only}
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Koren 2004 {published data only}
    1. Koren G, Maltepe C. Pre‐emptive therapy for severe nausea and vomiting of pregnancy and hyperemesis gravidarum. Journal of Obstetrics and Gynaecology. 2004;24(5):530‐3. - PubMed
Koren 2006 {published data only}
    1. Koren G. Pre‐emptive treatment of severe nausea and vomiting of pregnancy (ongoing trial, February 2015). ClinicalTrials.gov (http://clinicaltrials.gov/) [accessed 21 March 2006] 2006.
    1. Maltepe C, Koren G. Pre‐emptive treatment of nausea and vomiting of pregnancy: results of a randomised controlled trial. Obstetrics and Gynaecology International 2013;2013:Article no: 809787. - PMC - PubMed
Lask 1953 {published data only}
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Liu 2014 {published data only}
    1. Liu MC, Kuo SH, Lin CP, Yang YM, Chou FH, Yang YH. Effects of professional support on nausea, vomiting, and quality of life during early pregnancy. Biological Research for Nursing 2014;16(4):378‐86. - PubMed
Luz 1987 {published data only}
    1. Luz NP, Gonzales MAG. Effect of bromopride on nausea and vomiting during pregnancy. Personal communication 1987.
McCarthy 2014 {published data only}
    1. Higgins JR. Day care versus inpatient management of nausea and vomiting of pregnancy ‐ D.I.M. trial. Current Controlled Trials (http://controlled‐trials.com/) [accessed 5 January 2009].
    1. Higgins JR. Randomized controlled trial of day care versus inpatient management of nausea and vomiting of pregnancy. ClinicalTrials.gov (http://clinicaltrials.gov) [accessed 21 May 2013] 2008.
    1. McCarthy FP, Murphy A, Khashan AS, McElroy B, Spillane N, Marchocki Z, et al. Day care compared with inpatient management of nausea and vomiting of pregnancy: a randomized controlled trial. Obstetrics and Gynecology 2014;124(4):743‐8. - PubMed
Mehrolhasani 2012 {published data only}
    1. Mehrolhasani Y. Comparison of Demitron and promethazine in treatment of hyperemesis gravidarum. IRCT: Iranian Registry of Clinical Trials (www.irct.ir) (accessed 22 July 2013) 2012.
Pasha 2010 {published data only}
    1. Pasha NG. A comparison of ondansetron vs. metoclopramide for treatment of nausea and vomiting in pregnancy. IRCT Iranian Registry of Clinical Trials (www.irct.ir) (accessed 6 December 2010) 2010.
Reyhani 2013 {published data only}
    1. Reyhani M, Eskandari M. Evaluation of the Achillea millefolum effect in nausea and vomiting of early pregnancy. Iranian Journal of Pharmaceutical Research 2013;12(Suppl 2):232.
Shahbazzadegan 2006 {published data only}
    1. Ozgoli G, Shahbazzadegan S, Rasaeian N, Alavimajd H. Effect of acupressure with wristband on nausea and vomiting of pregnancy. Journal of Ardabil University of Medical Science 2007;7(3):247‐53.
    1. Shahbazzadegan S. Investigation the trend of pregnancy nausea and vomiting treatment using acupressure wristband. IRCT: Iranian Register of Clinical Trials (http://www.irct.ir) (accessed 30 April 2013) 2006.
Steele 2001 {published data only}
    1. Steele NM, French J, Gatherer‐Boyles J, Newman S, Leclaire S. Effect of acupressure by sea‐bands on nausea and vomiting of pregnancy. Journal of Obstetric, Gynecologic and Neonatal Nursing 2001;30(1):61‐70. - PubMed
Wheatley 1977 {published data only}
    1. Wheatley D. Treatment of pregnancy sickness. British Journal of Obstetrics and Gynaecology 1977;84:444‐7. - PubMed
Winters 1961 {published data only}
    1. Winters HS. Antiemetics in nausea and vomiting of pregnancy. Obstetrics & Gynecology 1961;18:753‐6. - PubMed

References to studies awaiting assessment

Abedian 2014 {published data only}
    1. Abedian Z. The effect of telephone support on health‐related quality of life in women with nausea and vomiting of pregnancy. IRCT: Iranian Register of Clinical Trials (www.irct.ir/) [accessed 19 January 2015] 2014.
Adamczak 2007 {published data only}
    1. Adamczak J, Kasdaglis J, Rinehart B, Antebi Y, Wolf E, Terrone D. A prospective randomized trial of solumedrol dose pack vs. phenergan for the treatment of symptomatic nausea and vomiting in pregnancy. American Journal of Obstetrics and Gynecology 2007;197(6 Suppl 1):S88, Abstract no: 277.
Babaee 2010 {published data only}
    1. Babaee PAG. Determining the effect of pyridoxine on nausea and vomiting in pregnancy. Journal of Maternal‐Fetal and Neonatal Medicine 2010;23(S1):129.
Hsu 2003 {published data only}
    1. Hsu E, Pei V, Shofer FS, Abbuhl SB. A prospective randomized controlled trial of acupressure vs sham for pregnancy‐related nausea and vomiting in the emergency department. Academic Emergency Medicine 2003;10(5):437.
Mamo 1995 {published data only}
    1. Mamo J, Mamo D, Pace M, Felice D. Evaluation of sea‐band acupressure device for early pregnancy nausea and vomiting. 27th British Congress of Obstetrics And Gynaecology; 1995 July 4‐7; Dublin, Ireland. 1995:283.
Narenji 2014 {published data only}
    1. Narenji F. Comparison the effects of ginger powder and fresh root of ginger and Vit B6 on nausea and vomiting in pregnancy. IRCT: Iranian Register of Clinical Trials (www.irct.ir/) [accessed 19 January 2015] 2014.
    1. Narenji F, Delaver M, Rafiei M. Comparison the effects of the ginger fresh root and vitamin B6 on the nausea and vomiting in pregnancy. Iranian Journal of Obstetrics, Gynaecology and Infertility 2012;15(2):39‐43.
Paridokht 2010 {published data only}
    1. Paridokht A, Gholamreza B. Determine effect VB6 on nausea and vomiting of pregnancy. Journal of Maternal‐Fetal and Neonatal Medicine 2010;23(S1):127‐8.
Smith 1991 {published data only}
    1. Smith EA, Smith GL. Acupressure to control nausea and vomiting during pregnancy. Masters Abstracts International 1991; Vol. 29, issue 4:651.

References to ongoing studies

Dehkordi 2013 {published data only}
    1. Dehkordi EJ. Comparison of "Cydonia Oblonga" fruit product with B6 on nausea and vomiting in pregnancy. IRCT: Iranian Register of Clinical Trials (www.irct.ir) [accessed 30 April 2013] 2013.
Faramarzi 2013 {published data only}
    1. Faramarzi M. The comparison of effectiveness of supportive psychotherapy and pharmacotherapy with ondansetron to improvement of nausea and vomiting of pregnancy. IRCT: Iranian Register of Clinical Trials (www.irct.ir) [accessed 1 May 2013] 2013.
Farhadifar 2011 {published data only}
    1. Farhadifar F. Comparing the effects of ginger and metoclopramid on the treatment of pregnancy nausea. IRCT: Iranian Register of Clinical Trials (www.irct.ir) [accessed 30 April 2013] 2011. - PubMed
Keshavarz 2014 {published data only}
    1. Keshavarz M. Comparison the effect of Lavender and mint oil on nausea, vomiting and anxiety in pregnant women. IRCT: Iranian Register of Clinical Trials (www.irct.ir/) [accessed 19 January 2015] 2014.
Koren 2014 {published data only}
    1. Koren G. A multicenter trial of the efficacy and safety of Diclegis for nausea and vomiting of pregnancy in pregnant adolescents. ClinicalTrials.gov (http://clinicaltrials.gov/) [accessed 5 February 2014] 2014.
Ozgoli 2011 {published data only}
    1. Ozgoli G. Study of Cardamom powder effect on the severity of nausea and vomiting in pregnant women referred to health centers in Chalus city 1389‐90. IRCT: Iranian Register of Clinical Trials (http://www.irct.ir) [accessed 30 April 2013] 2011.
Ozgoli 2014 {published data only}
    1. Ozgoli G. Determination the effect of inhaled peppermint aroma on the severity of nausea and vomiting of pregnancy in women. IRCT: Iranian Register of Clinical Trials (http://www.irct.ir/) [accessed 19 January 2015] 2014.
Safajou 2014 {published data only}
    1. Safajou F. The effect of combined inhaler aromatherapy on nausea and vomiting of pregnancy: a randomised controlled trial. IRCT: Iranian Register of Clinical Trials (http://www.irct.ir/) [accessed 19 January 2015].

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