Fatemeh Aliasl1, Tayebeh Toliyat2, Jale Aliasl3, Mohammd-Bagher Minaee4. 1. Dept. of Traditional Pharmacy, Faculty of Traditional Medicine Tehran University of Medical Science, Tehran, Iran. 2. Dept. of Pharmaceutics Faculty of Pharmacy, Tehran University of Medical Science, Tehran, Iran. 3. Traditional Medicine Clinical Trial Research Center, Shahed University, Tehran, Iran. 4. Dept. of Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Science, Tehran, Iran ; Dept. of Histology, School of Medicine, Tehran University of Medical Science, Tehran, Iran.
Nausea and vomiting are common in pregnant women. Prevalence of nausea is between 50% – 80% and the rate of vomiting and retching is 50% (1). There are various pharmacologic treatments for nausea and vomiting in pregnancy such as vitamin B6, doxylamine, metoclopramide, and ondansetron. Although, they have positive effects, it is not possible to ignore their adverse effects (Table 1) (2).
Table 1:
Adverse effects of some drugs for nausea and vomiting in pregnancy
drugs
Adverse effects
Note
Vitamin B6
Paresthesias, headache, fatigue
First-line therapy
Doxylamine
Drowsiness
May use lower dose in the morning and at midday, and larger dose at night
Metoclopramide
Tardive dyskinesia
Avoid high dosages or treatment for longer than 12 weeks
Ondansetron
Headache, diarrhea, constipation, fatigue
Adverse effects of some drugs for nausea and vomiting in pregnancyTherefore it is necessary to find safer treatments. Nowadays, ginger is a popular remedy for Nausea and Vomiting of Pregnancy (NVP).In spite of ginger effect in treating of NVP, It has side effects such as gastric discomfort, heartburn and a commonly observed side effect of ginger is reflux (3).As a matter of fact, maternal health in pregnancy was given attention in ancient Iran (4). Etiology of nausea and vomiting can be due to effusion and accumulation of inappropriate substance in stomach. In fact, stomach weakness is one of the intriguing factors of this etiology (5, 6). Treatment consists of removing inappropriate substance from the stomach and decrease of its production. Therefore, suitable less food volume and more times, walking slowly (5, 6) and avoiding icy water drink are recommended (5). On the other hand, pregnant women should eat light and digestible foods like chicken and lamb (4, 5). Besides, for removing inappropriate substance, Sekanjabin “it is made by sugar and vinegar”, can be used with warm water (5, 6). Finally, for strengthening stomach quince or apple syrups are recommended (5, 6). It is better to add sumac and pomegranate to their food.If vomiting is persistent and continuous, other remedies such as lemon juice, mint and quince syrups should be used and. also and sour pomegranate seeds together with sweet ones be sucked (5, 6). Pomegranate sauce with mint leaves have good effect on NVP (6). If NVP induced after meal, it is better to use astringent flavor and fragrance, such as roast quince after meal orally, holding pomegranate seed and mint leaves in the mouth, extremities massage and rub suitable oil on stomach topically like rose oil (6). Accordingly based on ITM in 2013 a clinical study was evaluated quince fruit syrup effect on NVP and their result demonstrated the effect of quince syrup was significant (7). Since these remedies are simple and available, they should be recommended by the midwives and physician for decrees of NVP.