The effect of acupressure therapy on emesis gravidarum in pregnant women in the first trimester
DOI:
https://doi.org/10.53713/nhsj.v5i3.577Keywords:
acupressure, emesis gravidarum, first trimester, pregnancy, non-pharmacological therapyAbstract
Nausea and vomiting (emesis gravidarum) are among the most common complaints during the first trimester of pregnancy, often associated with elevated levels of human chorionic gonadotropin (hCG). Non-pharmacological interventions such as acupressure have been proposed as effective alternatives to manage these symptoms. This study aimed to evaluate the effectiveness of acupressure therapy in reducing the severity of emesis gravidarum among first-trimester pregnant women. A quasi-experimental design with a pretest-posttest control group was applied. A purposive sampling technique recruited 42 participants, divided equally into intervention (n=21) and control (n=21) groups. Acupressure therapy was administered to the intervention group at specific points, while the control group received routine antenatal care. Data were analyzed using paired t-test and independent t-test. The findings demonstrated a statistically significant reduction in the frequency and severity of nausea and vomiting in the intervention group compared to the control group (p < 0.001). Acupressure therapy effectively alleviated symptoms of emesis gravidarum during the first trimester. Acupressure therapy is a beneficial, non-pharmacological intervention for reducing emesis gravidarum in early pregnancy. This technique can be integrated into maternal health services to improve comfort and wellbeing.
References
Alves, A. C., Cecatti, J. G., & Souza, R. T. (2021). Resilience and Stress during Pregnancy: A Comprehensive Multidimensional Approach in Maternal and Perinatal Health. The Scientific World Journal, 2021(1), 9512854. https://doi.org/10.1155/2021/9512854
Azlan, W. A., Ramalingam, M., Razali, R., Abdullah, M. F., & Abdul Rahman, F. N. (2022). Anxiety, depression and marital satisfaction in women with hyperemesis gravidarum: A comparative cross-sectional study in Hospital Tengku Ampuan Rahimah, Klang, Malaysia. Asia-Pacific Psychiatry, 14(1), e12416. https://doi.org/10.1111/appy.12416
Crawford, A. D., Carder, E. C., Lopez, E., & McGlothen-Bell, K. (2023). Doula Support and Pregnancy-Related Complications and Death Among Childbearing Women in the United States: A Scoping Review. Journal of Midwifery & Women's Health, 69(1), 118-126. https://doi.org/10.1111/jmwh.13543
Dahab, A., Qurban, S., Altowyrqi, G., Aljuhani, R., Haij, J., Alkhunaizi, N., ... & Alshalawi, S. (2023). Presentation, Treatment, and Complications of Acute Dehydration in Hyperemesis Gravidarum. J Healthc Sci, 309, 339-45. http://dx.doi.org/10.52533/JOHS.2023.30909
Dunbar, K., Yadlapati, R., & Konda, V. (2022). Heartburn, nausea, and vomiting during pregnancy. Official journal of the American College of Gastroenterology| ACG, 117(10S), 10-15. https://doi.org/10.14309/ajg.0000000000001958
Elder, T. J., Iacurto, G., & Deys, L. (2025). Enhancing maternal wellbeing: A qualitative exploration of women's experiences of tailored education and holistic support while experiencing Hyperemesis Gravidarum. Midwifery, 141, 104258. https://doi.org/10.1016/j.midw.2024.104258
Gazal, A., Scarf, V., Kay-Smith, C., Gidaszewski, B., Chua, S., & Levett, K. (2025). What are the costs associated with nausea and vomiting in pregnancy and hyperemesis gravidarum? A systematic review. BMC Pregnancy and Childbirth, 25(1), 807. https://doi.org/10.1186/s12884-025-07921-5
Jain, S., Maheshwari, A., & Jain, S. K. (2022). Maternal Nutrition and Fetal/Infant Development. Clinics in Perinatology, 49(2), 313-330. https://doi.org/10.1016/j.clp.2022.02.005
Kaňková, Š., Hlaváčová, J., Roberts, K., Benešová, J., Havlíček, J., Calda, P., Dlouhá, D., & Roberts, S. C. (2023). Associations between nausea and vomiting in pregnancy, disgust sensitivity, and first-trimester maternal serum free β-hCG and PAPP-A. Hormones and Behavior, 152, 105360. https://doi.org/10.1016/j.yhbeh.2023.105360
Ke, X., Wang, F., & Lin, Y. H. (2022). Effect of blood pregnancy test time on IVF clinical outcomes in urine β-HCG-positive patients: A retrospective cohort study. https://doi.org/10.21203/rs.3.rs-1784219/v1
Lawrence, E. R., Klein, T. J., & Beyuo, T. K. (2022). Maternal Mortality in Low and Middle-Income Countries. Obstetrics and Gynecology Clinics of North America, 49(4), 713-733. https://doi.org/10.1016/j.ogc.2022.07.001
Levin, D., Levin, S., & Cohen, S. (2024). Effectiveness of P6 Stimulation and Transdermal Scopolamine Patch for the Reduction of Nausea and Vomiting During Caesarean Section Under Combined Spinal–Epidural Anesthesia: A Randomized Clinical Trial. Journal of Clinical Medicine, 14(7), 2521. https://doi.org/10.3390/jcm14072521
Li, Z., Jiang, M. Y., Liu, X., Cai, Y., Wang, C., Cao, F., & Liu, J. (2024). Research trends of acupressure from 2004 to 2024: A bibliometric and visualization analysis. Heliyon, 10(21), e38675. https://doi.org/10.1016/j.heliyon.2024.e38675
Lin, G., Kotha, P., & Chen, H. (2022). Understandings of acupuncture application and mechanisms. American Journal of Translational Research, 14(3), 1469. https://pmc.ncbi.nlm.nih.gov/articles/PMC8991130/
Liu, C., Zhao, G., Qiao, D., Wang, L., He, Y., Zhao, M., ... & Jiang, E. (2022). Emerging progress in nausea and vomiting of pregnancy and hyperemesis gravidarum: challenges and opportunities. Frontiers in Medicine, 8, 809270. https://doi.org/10.3389/fmed.2021.809270
Lowe, S. A., & Steinweg, K. E. (2022). Review article: Management of hyperemesis gravidarum and nausea and vomiting in pregnancy. Emergency Medicine Australasia, 34(1), 9-15. https://doi.org/10.1111/1742-6723.13909
Maslin, K., & Dean, C. (2022). Nutritional consequences and management of hyperemesis gravidarum: a narrative review. Nutrition Research Reviews, 35(2), 308-318. https://doi.org/10.1017/S0954422421000305
Medved, V. I., Zhuk, S. I., Konkov, D. H., Litvinov, S. K., & Ocheretna, O. L. (2023). The evidence bases of etiopathophysiology and preventive clinical management of nausea and vomiting in pregnancy. Reprod Health Women, 4, 13-28. https://doi.org/10.30841/2708-8731.4.2023.285760
Mudlikah, S. (2023). Acupressure Technique Point P6 (Nei Guan) to Reduce Nausea and Vomiting and Point L14 (Hegu) to Reduce Anxiety in Pregnant Women. EMBRIO: Jurnal Kebidanan, 15(2), 207-215. https://doi.org/10.36456/embrio.v15i2.7742
Mukuru, M., Gorry, J., Kiwanuka, S. N., Gibson, L., Musoke, D., & Ssengooba, F. (2021). Designed to Fail? Revisiting Uganda’s Maternal Health Policies to Understand Policy Design Issues Underpinning Missed Targets for Reduction of Maternal Mortality Ratio (MMR): 2000-2015. International Journal of Health Policy and Management, 11(10), 2124. https://doi.org/10.34172/ijhpm.2021.127
Nana, M., Morgan, H., Ahmed, H., & Williamson, C. (2022). Hyperemesis gravidarum in the primary care setting: cross-sectional study of GPs. BJGP open, 6(1). https://doi.org/10.3399/BJGPO.2021.0119
Nelson-Piercy, C., Dean, C., Shehmar, M., Gadsby, R., O'Hara, M., Hodson, K., Nana, M., & Royal College of Obstetricians and Gynaecologists (2024). The Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum (Green-top Guideline No. 69). BJOG : an international journal of obstetrics and gynaecology, 131(7), e1–e30. https://doi.org/10.1111/1471-0528.17739
Nency, O. ., & Nurseha, N. (2024). The Effectiveness of Acupressure in First Trimester Pregnant Women with Emesis Gravidarum at TPMB Nurseha in 2023. International Journal of Health and Pharmaceutical (IJHP), 4(2), 260–266. https://doi.org/10.51601/ijhp.v4i2.287
Permata, A. D. (2024). Pericardium Point 6 Acupressure For Nausea, Vomiting In 1st Trimester Pregnant Women: Case Study. Nursing Case Insight Journal, 2(2), 37-40. https://doi.org/10.63166/ha9mm875
Ramdaniati, S., Sitaresmi, M. N., Haryanti, F., & Iman, A. T. (2025). Acupressure intervention for children: A scoping review. Belitung Nursing Journal, 11(1), 1. https://doi.org/10.33546/bnj.3524
Rukmindar, D., Pekerti, F., Sirvel, R., Khasanah, N., Dimara, I., Mihardja, H., & Djaali, W. (2023). The Role of Self-Care Acupressure in Maternal Health Problems to Support the Sustainable Development Goals Program in the Health Sector: A Narrative Review. Medical Acupuncture, 35(4), 170-179. https://doi.org/10.1089/acu.2023.0001
Septyanti, S. S., & Dahlia, D. (2024). Effectiveness of Accupressure on Post Operative Nausea and Vomiting in Post Abdominal Surgery Patients A Systematic Review. Jurnal Keperawatan Respati Yogyakarta, 11(2), 73-79. https://doi.org/10.35842/jkry.v11i2.780
Tan, M., Shu, S., Liu, R., & Zhao, Q. (2023). The efficacy and safety of complementary and alternative medicine in the treatment of nausea and vomiting during pregnancy: A systematic review and meta-analysis. Frontiers in Public Health, 11, 1108756. https://doi.org/10.3389/fpubh.2023.1108756
Xu, S., Zhou, G., Wu, B., & Liu, T. T. (2024). Molecular and Circuit Mechanisms Regulating Nausea and Vomiting: Recent Advances and Future Perspectives. Neuropharmacology and Therapy, 1(1), 34-48. https://doi.org/10.15212/npt-2024-0006
Wang, X., Yang, G., Li, K., Yang, F., Liang, X., & Wu, S. (2024). Efficacy and safety of acupressure in nausea and vomiting during pregnancy: a systematic review and meta-analysis of randomized controlled trials. Archives of Gynecology and Obstetrics, 309(4), 1237-1248. https://doi.org/10.1007/s00404-023-07313-0
Yao, C., Zeng, X., Zhang, S., Xiao, B., Sun, P., Kong, L., ... & Fang, M. (2025). Acupoint massage: a comprehensive descriptive review of its forms, applications, and underlying mechanisms. Chinese Medicine, 20(1), 54. https://doi.org/10.1186/s13020-025-01105-1
Zhong, W., Shahbaz, O., Teskey, G., Beever, A., Kachour, N., Venketaraman, V., & Darmani, N. A. (2021). Mechanisms of nausea and vomiting: current knowledge and recent advances in intracellular emetic signaling systems. International journal of molecular sciences, 22(11), 5797. https://doi.org/10.3390/ijms22115797









