Title: Prospective Comparative Study of Ginger versus Combination of Doxylamine plus Pyridoxine in Alleviating Nausea and Vomiting of Pregnancy

Authors: Balwinder Kaur, Amanpreet Kaur, Manjit Mohi, Parveen Marwah, Surinder Kumari

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.109

Abstract

Nausea and vomiting of pregnancy are common and bothersome complaints of early pregnancy. Use of currently available medications is restricted due to potential teratogenic effect during embryogenisis So alternative natural therapies e.g. Ginger are preferred.

Objective:  Present study was to compare the safety, effectiveness of ginger versus combination of doxylamine plus pyridoxine in treating nausea and vomiting of pregnancy.

Methods: 250 women having nausea and vomiting of pregnancy up to 12 weeks gestation, fulfilling inclusion criteria were included & divided into 3 groups. (1) Ginger gp 100 women (II) Doxylamine plus Pyridoxine gp 100 women (III) Control 50 women. Each group was further classified into mild, moderate and severe, using the Rhodes Index of Nausea, Vomiting and retching (RINVR). Group I was given half teaspoon of liquid extract of fresh ginger (equivalent to 500mg standardized extract, twice daily for 4 days/ week.  Group II was given 2 tablets of Doxylamine (10mg) + pyridoxine (10mg) at bed time. If needed, one tablet was added in the morning and another in the afternoon.  Severity of NVP was evaluated 24 hrs before and upto 4 days after treatment by Rhodes Index. (1) Ginger is more effective as compared to control group. P values in mild, moderate and severe gp of nausea were 0.01(S),<0.001(HS), <0.038(S) and vomiting <0.0001(HS), ,<0.0001(HS) and 0.008(S) respectively. Group II is more effective than control. P values in mild, moderate, and severe gp of nausea were 0.02(S), <0.001(HS),<0.039(S) and vomiting <0.0001(HS),<0.0001(HS), 0.015(S) respectively. Ginger is more effective and safe as compared to Control and comparable to Doxylamine plus Pyridoxine..

Keywords:  Ginger, NVP, Placebo, Doxylamine, VitaminB6.

References

  1. Williams F,Gary Cunningham, Kenneth J. Levence, Steven L. Bloom et al:Prenatal care. In : Text book of Obstetrics. 22nd edition, 2005; Page number 224.
  2. Borelli F, Capasso R, Aviello G, Pittler MH, Izzo AA. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gyencol. 2005;105(4):849–56. [PubMed]
  3. Smith C, Crowther C, Williams K,Hotham N, McMillan V: A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Obstet Gynaecol 2004; 103: 639-645.
  4. (Eva Bryer,2005)-----Bryer E,CNM,MSN: Aliterature Review of Effectiveness of Ginger in Alleviating mild mild to moderate nausea and vomiting of pregnancy: J Midwifery Woman Health 2005; 50:e1-e3.
  5. American botanical council
  6. (Caddick R et ai,1995)---Caddick R, Colliton IE, Dushinski B. Guidelines f or the management ofnausea and vomiting in pregnancy. Society of Obstetriciean and Gynaecologists of Canada(SOGC). Clinical Practical Guidelines 1995; 12:1-4
  7. Jeffrey D, Aahley H,  nausea and vomiting of pregnancy  , ..... 2003 Jul 168(1):121-128. Am Fam Physician  
  8. Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U: Ginger treatment of hyperemesis gravidarum: Eur J obstet Gynaecol Reprod Biol 1990; 38: 19-24.
  9. Portnoi G, Chng LA, Karimi-Tabesh L, Koren G, Tan MP, Einarson A. Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Am J Obstet Gynecol. 2003; 189(5):1374–7 .  [PubMed]
  10. Smith C et al,2004 showed that ginger was theraputically equivalent to vit B6 for improving nausea, vomiting and dry retching.   
  11. Matthews A, Haas DM, O’Mathúna DP, Dowswell T, Doyle M. Interventions for nausea and vomiting in early pregna-ncy. Cochrane Database Syst Rev.  2014;(3):CD007575. [PubMed] (Inspite of limited evidence, some studies support ginger over placebo in relieving nausea vomiting of pregnancy.)
  12. Thomson M, Corbin R, Leung L. Effects of ginger for nausea and vomiting in early pregnancy: a meta-analysis. J Am Board Fam Med. 2014;27(1):115–22. [PubMed( GIinger is an effective non pharmacological treatment for nausea vomiting of pregnancy
  13. Willets KE , Ekangaki A, Eden JA. Effect of ginger extract on pregnancy-induced nausea: a randomized controlled trial. Aust N Z J Obstet Gynaecol. 2003 Apr;43(2): 139-44   
  14. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: Randomized  double- masked, placebo-controlled trial. Obstetrics and  Gynecology 2001; 97: 577-582.

Corresponding Author

Balwinder Kaur

Associate Professor, Dept of Obstetrics and Gynaecology, Govt. Medical College, Patiala, Punjab, India

360 North Avenue, Bhadson Road Patiala Punjab India, 147001

+919814486292, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.