• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.1
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• pp.234-241
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• 2005

Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy. It is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. The peak incidence is at 8-12 weeks of pregnancy, and symptoms usually resolve by week 16. Interestingly, nausea and vomiting of pregnancy is generally associated with a lower rate of miscarriage. The cause of severe nausea and vomiting in pregnancy has not been identified. Extreme nausea and vomiting may be related to elevated levels of estrogens or human chorionic gonadotropin. Once the diagnosis is made, treatment consists of mainly supportive care. Until vomiting is controlled, these patients should be maintained as NPO. We treated 1 patient who had hyperemesis gravidarum and visited Kyung-Won Incheon Oriental Hospital by Herbal medication, acupuncture, moxa and nega therapy and got good result from them.

• Korean Journal of Community Nutrition
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• v.8 no.2
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• pp.138-148
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• 2003

Morning sickness during pregnancy is a very common functional problem with different kinds of symptom, but little data are available concerning the nutrition intervention program fur pregnant women in local area. A total of 152 pregnant women who had experienced morning sickness were surveyed to investigate the relationships between morning sickness, nutrient intakes and pregnancy outcome. The results showed that prevalent symptoms were nausea (68.4%), heartburn (59.2%), morning sickness (48.7%), vomiting (42.1%), and constipation (44.7%). The onset of the symptom occurred during the first 3 months (9.3 $\pm$ 2.3 weeks) ; 21.1% of the subjects was experienced two symptom at the same time. This significantly correlated with vomiting (p < 0.01), nausea (p < 0.001), morning sickness (p < 0.001), and heartburn (p < 0.01) with pregnancy weight. There were also correlations between the four symptoms and nutrient intakes. Mean birth weight of 21 newborns was 3.06 $\pm$ 0.42 kg, and the one and five minutes of Apgar scores were 7.74 $\pm$ 0.99 and 8.84 $\pm$ 0.69, respectively. There were negative correlations between vomiting and pregnancy outcomes (p < 0.05). Our data support that morning sickness, especially vomiting during pregnancy is associated with Apgar score and body weight of newborn. (Korean J Community Nutrition 8(2) : 138~148, 2003)

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.3
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• pp.69-77
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• 2018

Pregnancy and delivery pose a high risk of developing metabolic decompensation in women with defects of ketone body metabolism. In this review, the available reported cases in pregnancy are summarized. It is very important to properly manage women with defects of ketone body metabolism during pregnancy, especially nausea and vomiting in the first trimester of pregnancy, and during labor and delivery. Pregnant women with deficiencies of HMG-CoA lyase or succinyl-CoA:3-ketoacid CoA transferase (SCOT) often experience metabolic decompensations with nausea and vomiting of pregnancy, often requiring hospitalization. For successful delivery and to reduce stresses, vaginal delivery with epidural anesthesia or elective cesarean delivery with epidural or spinal anesthesia are recommended for women with HMG-CoA lyase and SCOT deficiency. In beta-ketothiolase deficiency, four pregnancies in three patients had favorable outcomes without severe metabolic problems.

• Journal of Nutrition and Health
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• v.47 no.1
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• pp.45-50
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• 2014

Purpose: Ginger (Zingiber officinale) has been widely used as an antiemetic agent. This systematic review was aimed at evaluation of the effect of dried ginger powder supplementation on improvement of nausea and vomiting associated with early pregnancy or motion sickness. Methods: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) using keywords such as ginger or Zingiber officinale in combination with nausea, vomiting, motion sickness, or pregnancy, published in March 2013. Results: The strength of the evidence was evaluated on the selected 12 RCTs (randomized controlled trials). Eleven trials including 2,630 subjects showed that supplementation with dried ginger powder resulted in significant improvement of nausea or vomiting related to early pregnancy or motion sickness. Among the nine studies including 809 women in early pregnancy before 20 weeks of gestation, ginger supplementation was superior to placebo in five studies (n = 305), and as effective as positive control (vitamin $B_6$ or dimenhydrinate) in four studies (n = 504). Ginger intake significantly reduced the episodes or severity of vomiting related to motion sickness compared to placebo or showed the same effect as several antiemetic drugs in two studies (n = 1,821). Conclusion: Our findings added evidence indicating that ginger powder supplements might improve the symptoms of nausea or vomiting related to early pregnancy or motion sickness without significant adverse events.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.2
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• pp.69-84
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• 2023

Objectives: This study was conducted to reflect the public's perspective when developing Korean Medicine (KM) Clinical Practice Guideline (CPG) for nausea and vomiting of pregnancy (NVP). Methods: 317 respondents who had experienced nausea and vomiting during current or past pregnancy completed the questionnaire online, and we analyzed their answers. Results: 1. 24% of all respondents had received KM treatment. The most common reason for choosing KM treatment was "it would be relatively safe for pregnant women and fetuses", and the reason for not choosing KM treatment was "they did not know much about it". 2. Respondents who had experienced KM treatment for NVP had felt the effects of KM treatment (79%), and chose herbal medicine as the most effective and preferred treatment. 3. 64.1% of respondents who had not experienced KM treatment for NVP preferred cooperative treatment with Western medicine. They answered that herbal medicine would be the most effective treatment, but preferred acupuncture. 4. The most important factor when treating NVP was "the safety of treatments". 59% of all respondents perceived KM treatment is safe for NVP. The treatments perceived as safest were herbal medicine and acupuncture, while the treatments with the least safety information were pharmacopuncture and electro-acupuncture. 5. Treatments that medical consumers were comprehensively interested in were acupuncture, KM treatment & Fluid, herbal medicine, moxibustion, and acupressure, in order. Conclusions: This study revealed the public's experience of using medical care, preference and perception of KM treatment for NVP. Therefore we would reflect the patients' clinical needs in the CPG.

• The Journal of Korean Obstetrics and Gynecology
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• v.26 no.2
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• pp.138-150
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• 2013

Objectives: To observe randomized controlled trials(RCTs) related to investigating the effects of acupoint treatments on nausea and vomiting in pregnancy to establish the basis of korean medical treatments, and suggest the problems of future clinical research. Methods: After searching for national and international papers published after 2000 and restricting the parameters to 'clinical trial', 'controlled clinical trial', 'randomized controlled trial', then comparing the subjects, methods, research tools, and results to understand the effects and re-comparing the conflicting results to assume the cause. Results: Of the 9 research papers that applied acupressure, four of them used control and experimental groups, and three(75%) research papers indicated significant reduction in vomiting and nausea, and of the seven research papers that utilized the experimental and placebo groups, five(71.4%) reported significant reducing effects. Of the four research papers the used acupuncture treatments, four research papers using control and placebo groups, two showed improvements in symptoms but did not have significant results compared to sham acupuncture groups, and two showed significant reduction of symptoms compared to the control groups. The one research paper that used electrical stimulation showed significant results in the reduction of vomiting and nausea compared to the control group. Conclusions: Acupressure and electrical stimulation showed efficacy reducing the symptoms. Acupuncture treatments did not indicate efficacy some experiments. Therefore it is thought that future acupuncture treatments should use methods that resemble actual clinical medicine to establish efficacy to produce significant results.

• Journal of Korean Medical classics
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• v.32 no.2
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• pp.147-163
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• 2019

Objectives : Morning Sickness, or Nausea and Vomiting of Pregnancy(NVP) is a frequently experienced phenomenon among pregnant women whose cause is still unknown. While the key trait of this symptom is its temporality, it is hardly considered in existing studies on the cause of NVP based on Korean Medical(KM) literature. We hope to remedy this. Methods : We looked for contents on fetal development in Korean Medical literature from the Siku Quanshu as well as other key literature of KM and examined the results together with contents on NVP to find any correlation. Results : We found that the beginning stages, namely the third month marked a significant change in the course of fetal development where the fetus's own Shen(神) is first developed by work of the mother's Heart(心). In other words, the third month is when the mother's and child's Shen first encounter. Conclusions : We hypothesized that NVP whose symptoms are closely linked to the functions of the Heart, is likely to be related to this event, which was supported by the common involvement of the Heart which was involved in both fetal development and NVP during the third month of pregnancy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3877-3880
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• 2016

Nausea and vomiting are among the most serious side effects of chemotherapy, in some cases leading to treatment interruption or chemotherapy dose reduction. Ginger has long been known as an antiemetic drug, used for conditions such as motion sickness, nausea-vomiting in pregnancy, and post-operation side effects. One hundred and fifty female patients with breast cancer entered this prospective study and were randomized to receive ginger (500 mg ginger powder, twice a day for 3 days) or placebo. One hundred and nineteen patients completed the study: 57 of them received ginger and 62 received ginger for the first 3 chemotherapy cycles. Mean age in all patients was 48.6 (25-79) years. After 1st chemotherapy, mean nausea in the ginger and control arms were 1.36 (${\pm}1.31$) and 1.46 (${\pm}1.28$) with no statistically significant difference. After the $2^{nd}$ chemotherapy session, nausea score was slightly more in the ginger group (1.36 versus 1.32). After $3^{rd}$ chemotherapy, mean nausea severity in control group was less than ginger group [1.37 (${\pm}1.14$), versus 1.42 (${\pm}1.30$)]. Considering all patients, nausea was slightly more severe in ginger arm. In ginger arm mean nausea score was 1.42 (${\pm}0.96$) and in control arm it was 1.40 (${\pm}0.92$). Mean vomiting scores after chemotherapy in ginger arm were 0.719 (${\pm}1.03$), 0.68 (${\pm}1.00$) and 0.77 (${\pm}1.18$). In control arm, mean vomiting was 0.983 (${\pm}1.23$), 1.03 (${\pm}1.22$) and 1.15 (${\pm}1.27$). In all sessions, ginger decreased vomiting severity from 1.4 (${\pm}1.04$) to 0.71 (${\pm}0.86$). None of the differences were significant. In those patients who received the AC regimen, vomiting was less severe ($0.64{\pm}0.87$) comparing to those who received placebo ($1.13{\pm}1.12$), which was statistically significant (p-Value <0.05). Further and larger studies are needed to draw conclusions.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.4
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• pp.279-286
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• 2006

Purpose : The purpose of this study is to report the effect of oriental treatments to hyperemesis gravidarum in disturbed liver function. Methods : Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy. It is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. The peak incidence is at 4, 8-16 weeks of pregnancy. Interestingly, nausea and vomiting of pregnancy is generally associated with a lower rate of miscarriage. However disturbed diver dunction with Hyperemesis gravidarium is rare very and dangerous. Traditionally, oriental medical therapy has been used to patients with hyperemesis gravidarum and showed effective result. We treated 1 patient who had hyperemesis gravidarum in disturbed diver dunction at Se-Myung university Oriental Hospital in affiliation by Herbal medication, acupuncture and moxa therapy and got good result from them. Results : As a result, symptoms are remarkably alleviated and liver function test are improved. Conclusion : Therefore we would like to report that it is effective to cure the hyperemesis gravidarum in disturbed liver function through the herb-medication and acupuncture treatment.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.2
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• pp.36-54
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• 2023

Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.