Effect of acupuncture on nausea and vomiting in pregnancy

Up to 90% of pregnant women experience nausea and vomiting. Hyperemesis gravidarum is an extreme end of hyperemesis or morning sickness which is prolonged and severe nausea and vomiting in pregnancy. One of the main dangers of this condition is dehydration. Women with hyperemesis gradidarum could be constantly nausea and vomiting many times a day and it is difficult to keep fluids within the body. It could cause lot of weight loss, electrolyte imbalance and blood volume depletion. This condition is caused by hormone in pregnancy and is improved when the hormone levels go down as pregnancy turns to 13 weeks. Sometimes it could continue throughout of pregnancy. This condition is not likely to cause any harm to the baby. But there is a risk of the baby being born with a low birth weight if there is a significant weight loss during the pregnancy. Intravenous fluids and medication are used to control the vomiting and nausea.

Foods in rich carbohydrates and low fat and acid are recommended. Recommended foods include Light snacks, nuts, dairy products, beans and dry and salty biscuits. Electrolyte-replacement drinks and taking nutritional supplements are beneficial for maintenance of electrolyte balance and sufficient calories. Intake of food rich in protein is recommended. Use of ginger and vitamin B6 are effective though there is limited evidence.

Acupuncture was used in China to treat morning sickness. Carisson CP et al from University Hospital, Lund Sweden conducted a randomized placebo controlled trial to study the effect of acupuncture in treating morning sickness. Acupuncture treatments were given three times daily on treatment days. Each treatment lasted for 30 minutes. Acupuncture point PC6 was selected. Women in the acupuncture group had significantly quicker decrease in the amount of nausea they experienced compared with the placebo control group. There was also a significant difference in the amount of vomiting between the acupuncture and placebo groups. In acupuncture group there were fewer patients vomiting. There was no significant difference of food intake between the two groups. There were no side effects observed. The possible mechanisms for the acupuncture inhibiting nausea and vomiting include that acupuncture inhibits nociceptive transmission and autonomic reflexes; acupuncture decreases pain in the system; acupuncture has effect on gastric intestine tract; the effect of acupuncture is through somatovisceral reflexes.

NHS service shows: acupuncture help your birth preparation to normalise birth.

Research has shown that acupuncture may help with labour and delivery. An NHS maternity acupuncture service providing birth preparation acupuncture has assessed its routine hospital maternity annual data from 2014 to 2016 to see what effect it had on labour and delivery outcomes. The data from this service was analysed and women who had birth preparation acupuncture were compared with those who did not receive it.

Results shown that women who received birth preparation acupuncture had more normal births (less surgical births), required less intrapartum analgesia, fewer components of an induction of labour and a reduced length of a hospital stay. The patients highly valued the availability of acupuncture within the maternity service as it enhanced their patient journey. Acupuncture for birth preparation effects include musculoskeletal preparation of the pelvis, cervical ripening, enhancing endogenous oxytocin release, and analgesic properties. This study supports the use of maternity acupuncture in normalising birth outcomes.

References
Lokugamage AU et al J Obstet Gynaecol. 2020 Jan 23:1-6. doi: 10.1080/01443615.2019.1694878. [Epub ahead of print]

Acupuncture in Italy

Acupuncture spread across Italy in 1960s and 1970s following other Western countries with a short delay, though the first descriptions of acupuncture reached Italy after Matteo Ricci (1552-1610)’s travels in China.

In 1968, the first medical and scientific acupuncture society was founded named as SIA (Italian Acupuncture Society); it followed a traditional approach adopting the principles of the Chinese medical philosophy.  In 1973, the SIRAA (Italian Society of Reflexotherapy, Acupuncture, and Auriculotherapy) was founded which recognised acupuncture to its neurophysiological mechanisms.

In 70s acupuncture was first taught in Italian schools of acupuncture by French teachers. At that time, patients were few, and acupuncture practitioners received insufficient and superficial training.

The real rise in interest of acupuncture occurred in 80s due to the scientific relationships established first with foreign acupuncture schools, above all from the Anglo-Saxon countries and then in later 90 s, with the universities of traditional Chinese medicine in China. Consequently, both teaching activities and clinical practice improved.

In 1987, the founding of the FISA (Italian Federation of Acupuncture Societies) was a milestone for the growth of acupuncture in Italy: The past—represented by the two previous scientific societies, that is, SIA and SIRAA—was superseded by both a political and scientific perspective.

Today, FISA is the leading self-regulatory body for the practice of acupuncture in Italy and represents most Italian MD acupuncturists. It is the only Italian scientific society of acupuncture to be accredited by the Ministry of Health. Its members include 19 medical associations and 13 schools of acupuncture. Since its foundation, 4,187 MDs have been trained and certified by FISA until December 31, 2018. In addition, FISA coordinates national resources, offers assistance, and disseminates information related to acupuncture and TCM to create opportunities for youth to achieve successful futures.

FISA standards are recognized by regional, national, and international associations, institutions, and organizations. FISA has fostered alliances with regional governments and assisted the Ministry of Health in many assignments.

In 1982, the Italian Supreme Court of Cassation asserted that medical doctors could exclusively practice acupuncture. Since then, only people with a degree in medicine and surgery who passed the state exam and were properly certified as a medical doctor could practice acupuncture.

In 2011, FISA President Carlo Maria Giovanardi was appointed Expert of the Superior Health Council for Non-Conventional Medicine. This appointment proved the growing interest of prestigious institutions, such as the Superior Health Council, in acupuncture. Consequently, FISA played a key role in establishing requirements and coordinating teaching activities for education in acupuncture at the State–Regions Conference held on February 7, 2013.

Over the last few years, acupuncture has increasingly spread in Italy. Nowadays, it is administered not only in private clinics, but also in public structures belonging to the National Healthcare Service. When acupuncture was first introduced in Italy, it was mainly used to treat the symptoms of pain syndromes. Therefore, it is most used in public pain relief centers. Over time, its range of application has remarkably increased; it now covers a wide variety of fields, including the treatment of chemotherapy-induced side effects in cancer patients, among others.

References

Giovanardi CM et al Integr Med Res. 2020 Mar;9(1):1-4. doi: 10.1016/j.imr.2019.12.001. Epub 2019 Dec 17.