Interventions for treating hyperemesis gravidarum: a network meta-analysis of randomized clinical trials

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#acupuncture-therapy #antiemetics #female #hospitalization #humans

Interventions for treating hyperemesis gravidarum: a network meta-analysis of randomized clinical trials

Sridharan et al., 2020 | J Matern Fetal Neonatal Med | Other

Citation

Sridharan Kannan, Sivaramakrishnan Gowri. Interventions for treating hyperemesis gravidarum: a network meta-analysis of randomized clinical trials. J Matern Fetal Neonatal Med. 2020-Apr;33(8):1405-1411. doi:10.1080/14767058.2018.1519540

Abstract

Background: Several interventions were explored in clinical trials for treating hyperemesis gravidarum (HG). The present study is a network meta-analysis of such interventions.Methods: Electronic databases were searched for appropriate randomized clinical trials comparing interventions for treatment of patients with HG. Control of HG symptoms was the primary outcome and emetic episodes, hospital stay, nausea scores, patients requiring rescue antiemetics, hospital readmission, adverse events, and adverse pregnancy outcomes were the secondary outcome measures. Random-effects model was used and odds ratio (OR) [95% confidence interval (CI)] was the effect estimate for categorical outcomes and weighted mean difference (WMD) [95% confidence interval] for numerical outcomes.Results: Twenty studies were included in the systematic review and 18 in the meta-analysis. Acupuncture (OR: 18.9; 95% CI: 2.1, 168), acupressure (OR: 26.7; 95% CI: 2.5, 283.1) and methylprednisolone (OR: 6.7; 95% CI: 1.1, 38.8) were associated with better control of HG symptoms than standard of care. Acupressure decreases the requirement of rescue antiemetics (OR: 0.06; 95% CI: 0.01, 0.44); ondansetron with reduced hospital stay (WMD: -0.2; 95% CI: -0.31, -0.01) and diazepam with reduced risk of hospital admission (OR: 0.11; 95% CI: 0.01, 0.95). The quality of evidence is very low.Conclusion: Acupuncture, acupressure, and methylprednisolone were observed with better therapeutic benefits than other interventions for treating HG. However, the pooled estimates may change with the advent of results from future head-to-head clinical trials.

Key Findings

Twenty studies were included in the systematic review and 18 in the meta-analysis. Acupuncture (OR: 18.9; 95% CI: 2.1, 168), acupressure (OR: 26.7; 95% CI: 2.5, 283.1) and methylprednisolone (OR: 6.7; 95% CI: 1.1, 38.8) were associated with better control of HG symptoms than standard of care. Acupressure decreases the requirement of rescue antiemetics (OR: 0.06; 95% CI: 0.01, 0.44); ondansetron with reduced hospital stay (WMD: -0.2; 95% CI: -0.31, -0.01) and diazepam with reduced risk of hospita

Outcomes Measured

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Population

Field Value
Population hg
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Acupuncture Therapy
  • Antiemetics
  • Female
  • Hospitalization
  • Humans
  • Hyperemesis Gravidarum
  • Pregnancy
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Other
  • Publication Types: Journal Article, Network Meta-Analysis
  • Vertical: ginger

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09