Morning sickness treatment still elusive: Review

By Dr. Ananya Mandal, MDSep 7 2010

According to experts we are nowhere near establishing safe and effective ways to treat morning sickness. Since the Thalidomide disaster in 1960’s that led to severe birth defects in the infants, this area of research is scary and less explored by many researchers. Despite its name, the vomiting and nausea of morning sickness can occur at any time of the day and affect about half of pregnant women. Between 70% and 85% of women will experience nausea during pregnancy, with about half suffering vomiting. Around 2% will experience it so badly they need to be hospitalised.

According to the acclaimed international group of researchers from Cochrane, alternative therapies are of little help as shown by evidence. The Cochrane researchers assessed 27 strictly controlled trials involving more than 4,041 women who were up to 20 weeks pregnant. These included six studies of acupressure and two of acupuncture and no significant benefit was noted with these methods. One study of acustimulation - the mild electrical stimulation of acupuncture points - did document some improvement. Ginger in the form of biscuits to tablets or vitamin B6 showed some benefits in the condition. Slight evidence of efficacy was seen with antihistamines and anti-vomiting drugs including Debendox, which was withdrawn from the market in the UK but is routinely prescribed in Canada.

All in all nothing concrete has come of research in this field say reviewers. In UK doctors prescribe antihistamines promethazine and cyclizines for severe sickness. Dr Anne Matthews, of the School of Nursing at Dublin City University, lead researcher said, “Despite the wealth of different treatments available, it is not possible currently to identify with confidence any safe and effective interventions for nausea and vomiting in early pregnancy…The difficulties in interpreting the results of the studies highlight the need for further, more rigorous trials in this area.”

According to Dr Brian Swallow, a health psychologist and member of Pregnancy Sickness Support, “At present treatment varies according to the woman's geographical location…Some areas are very good, whereas others have not developed appropriate treatment protocols. There is very little research that that aims to help women with nausea and vomiting in pregnancy…In terms of treatments, the most effective appear to be anti-nausea medication. GPs are often reluctant to administer them because they are fearful that they may have harmful effects on the foetus - although there is no evidence to suggest that they have.”