The effectiveness of aromatherapy in reducing pregnancy induced nausea and vomiting

Abstract

Topic Overview: Mild to moderate nausea and vomiting are two almost inevitable symptoms experienced by pregnant women during pregnancy. These symptoms not only affect the physical health of pregnant women, but also have a significant impact on the quality of life in terms of psychosocial aspects. In this dissertation, the effect of aromatherapy via inhalation to reduce mild to moderate nausea and vomiting of pregnancy (NVP) will be explored. Research Question: Does aromatherapy reduce pregnancy induced nausea and vomiting? PICO Elements: The population (P) studied comprised of pregnant women. The intervention (I) under review was aromatherapy via inhalation. The comparison intervention (C) was a placebo. The desired outcome (O) was a reduction in mild to moderate nausea and vomiting. Method: Various keywords and alternative words/synonyms based on the PICO framework were either used alone or amalgamated with various search tools in order to conduct a full search strategy. Limiters were also applied to filter irrelevant results according to a number of criteria. Four databases together with a search engine were searched for relevant articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram was used as a screening framework for relevant studies. Five randomized controlled trials (RCTs) met the inclusion/exclusion criteria and were incorporated in this dissertation. Meta-analysis, systematic reviews and randomized controlled trials together with observational studies that include cohort, cross sectional studies and case control studies which took into account inhalation as the method of aromatherapy application to reduce mild to moderate NVP were included. However, case series studies and case reports, ideas, editorials, opinions and animal research together with studies which focused on other methods of aromatherapy application were excluded. In addition, nausea and vomiting as a result of postoperative and chemo-induced were also excluded together with hyperemesis gravidarum (HG). The RCT Critical Appraisal Skills Programme (CASP) tool was then utilised to critically appraise the five RCTs. Results: Study outcomes favouring aromatherapy via inhalation were not consistent throughout all the five studies. In fact, three out of five studies presented better outcomes amongst those receiving the intervention. These inconsistencies could be a result of various methodological limitations and bias identified throughout the appraisal process. Conclusion: Although a concrete conclusion cannot be presented, the evidence indicated that aromatherapy via inhalation involving ginger, lemon, and peppermint oil combined with lemon were found to be effective in reducing mild to moderate NVP. Nevertheless, additional research is required in the area to answer the PICO question. Implications and Recommendations: Recommendations for further research include conducting studies in Western countries with longer intervention periods and follow up. In addition, these studies should also address the appropriate time span, dosage and distance required for such intervention. Moreover, complementary alternative medication (CAM) should also be included in various educative curriculums. The importance of keeping up-to-date with the latest research and the use of several media to raise awareness was also discussed.