Effectiveness of Acupressure at PC6 versus ST36 Points on Nausea and Vomiting in First-Trimester Pregnant Women: A Quasi-Experimental Study

Gusti Ayu Tirtawati; Ni Ketut  Somoyani; Ni Luh Putu Sri  Erawati; Putri  Yuniartis; Siti Rahmadani  Nasution

doi:10.56303/jhnresearch.v4i3.847

Authors

Gusti Ayu Tirtawati Poltekkes Kemenkes Denpasar, Indonesia
Ni Ketut Somoyani Poltekkes Kemenkes Denpasar, Indonesia
Ni Luh Putu Sri Erawati Poltekkes Kemenkes Denpasar, Indonesia
Putri Yuniartis Poltekkes Kemenkes Jakarta I, Indonesia
Siti Rahmadani Nasution Poltekkes Kemenkes Jakarta I, Indonesia

Keywords:

Acupressure, Nausea, PC6, Pregnancy, ST36, Vomiting

Abstract

The high incidence of nausea and vomiting during pregnancy, which affects 60-80% of primigravidas and 40-60% of multigravidas in Indonesia, can lead to complications such as dehydration and malnutrition if not managed effectively. This can have a negative impact on maternal health and fetal development. While pharmacological treatments are available, non-pharmacological interventions such as acupressure are gaining attention as a safe and effective alternative. This study aimed to determine and compare the effectiveness of acupressure at PC6 and ST36 points in reducing nausea and vomiting among first-trimester pregnant women. A comparative quasi-experimental design was used with a total sample of 50 pregnant women, divided into two groups: one receiving acupressure at PC6 and the other at ST36. The severity of nausea and vomiting was measured using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) questionnaire before and after the intervention. The results showed a significant decrease in nausea and vomiting scores in both groups (p < 0.001). The mean score reduction was 6.64 in the PC6 group and 6.32 in the ST36 group. Statistical analysis indicated no significant difference between the two groups, suggesting comparable efficacy (p = 0.214). These findings suggest that acupressure at both PC6 and ST36 points is an effective non-pharmacological method for managing nausea and vomiting in early pregnancy. Thus, ST36 can be considered a viable alternative point for treatment

Downloads

Download data is not yet available.

References

Vadakekut ES, Mahdy H. Hyperemesis Gravidarum. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Sept 15]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK532917/

Putri WT. Case Study On Primigravida In The First Trimester With Emesis Gravidarum In The Tongguh Community Health Center Area Bangkalan Regency. Fetus J Midwifery. 2024 Sept 25;1(1):101–12.

Nijsten K, Jansen LAW, Limpens J, Finken MJJ, Koot MH, Grooten IJ, et al. Long-term health outcomes of children born to mothers with hyperemesis gravidarum: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022 Sept 1;227(3):414-429.e17.

Bella SCS, Idris SBMS, Selomo PAM. Prevalence of Hyperemesis Gravidarum Based on Age, Parity, and Severity. J Indones Sos Sains. 2025 Aug 7;6(8):2514–9.

Citrawati NK, Arwidiana I dewa P. Characteristic Description of Emesis Gravidarum Case to Pregnant Woman in 1st Trimester. Indones J Glob Health Res. 2023 May 2;5(2):217–22.

Bustos M, Venkataramanan R, Caritis S. Nausea and Vomiting of Pregnancy-What’s New? Auton Neurosci Basic Clin. 2017 Jan;202:62–72.

Rorrong JF, Wantania JJE, Lumentut AM. Hubungan Psikologis Ibu Hamil dengan Kejadian Hiperemesis Gravidarum. E-Clin. 2021;9(1):218–23.

Shah R, Malhamé I, Fayek M, Merolli A, Mehta N. Wernicke’s encephalopathy: An uncommon complication from hyperemesis gravidarum. Obstet Med. 2020 Dec;13(4):198–200.

Petry CJ, Ong KK, Beardsall K, Hughes IA, Acerini CL, Dunger DB. Vomiting in pregnancy is associated with a higher risk of low birth weight: a cohort study. BMC Pregnancy Childbirth. 2018 May 4;18(1):133.

Gerede A, Stavros S, Moustakli E, Potiris A, Orgianelis I, Zikopoulos A, et al. Hyperemesis in Pregnancy: Complications and Treatment. Med Sci. 2025 Aug 14;13(3):132.

Wills L, Hsiao HF, Thomas A, Kay-Smith C, Henry A, Grzeskowiak LE. Assessing the burden of severe nausea and vomiting of pregnancy or hyperemesis gravidarum and the associated use and experiences of medication treatments: An Australian consumer survey. PLOS ONE. 2025 Sept 3;20(9):e0329687.

Mohd Nafiah NA, Chieng WK, Zainuddin AA, Chew KT, Kalok A, Abu MA, et al. Effect of Acupressure at P6 on Nausea and Vomiting in Women with Hyperemesis Gravidarum: A Randomized Controlled Trial. Int J Environ Res Public Health. 2022 Sept 1;19(17):10886.

Christiani N, Bitara INW. Effectiveness of Point ST36 (Zusanli) Acupressure on Emesis Gravidarum First Trimester in the Tengaran Health Center. Proc Int Conf Health Sci Pract Educ. 2025 Jan 2;463–71.

Koren G, Piwko C, Ahn E, Boskovic R, Maltepe C, Einarson A, et al. Validation studies of the Pregnancy Unique-Quantification of Emesis (PUQE) scores. J Obstet Gynaecol. 2005 Apr 1;25(3):241–4.

Tanjung WW, Wari Y, Antoni A. Pengaruh Akupresur pada Titik Perikardium 6 terhadap Intensitas Mual Muntah pada Ibu Hamil Trimester I. J Educ Dev. 2020 Nov 1;8(4):265–265.

Holisoh S, Hernawati Y, Kartika I. Pengaruh Akupresure Titik Pericardium ( Pc 6 ) Pada Mual Muntah Ibu Hamil Di PMB Bidan E Kabupaten Bandung. J Sehat Masada. 2023 July 21;17(2):73–9.

Chernyak GV, Sessler DI. Perioperative Acupuncture and Related Techniques. Anesthesiology. 2005 May;102(5):1031–78.

Yang J, Jiang Y, Chen Y, Sun M, Chen J, Zheng Q, et al. Acupressure the PC6 point for alleviating postoperative nausea and vomiting. Medicine (Baltimore). 2019 Aug 16;98(33):e16857.

Abbate S, Maciocia G, editors. Advanced Techniques in Oriental Medicine [Internet]. Stuttgart: Georg Thieme Verlag; 2006 [cited 2025 Sept 15]. Available from: http://www.thieme-connect.de/DOI/DOI?10.1055/b-002-52045

Oktaviani R, Mardiyono M, Achiriyati D. Acupressure On Zusanli (St36) And Taibai (Sp3) in Reducing Nausea for Patients with Dyspepsia at Banyumas Hospital. Nurse Media J Nurs. 2014 July 7;4(2):745–53.

Zhang Y, Tang YW, Zhou J, Wei YR, Peng YT, Yan Z, et al. Electroacupuncture at ST36 ameliorates gastric dysmotility in rats with diabetic gastroparesis via the nucleus tractus solitarius-vagal axis. World J Gastroenterol. 2025 June 7;31(21):107395.

Tang YW, Zhang Y, Zhou J, Peng YT, Zi Y, Wei YR, et al. Electroacupuncture with different current intensities can improve gastrointestinal motility in diabetic gastroparesis via vagal and sympathetic pathways. World J Diabetes. 2025 Aug 15;16(8):107779.

Li S, Ye F, Zhang S, Liu Y, Chen JDZ. Effect and Mechanism of Vagal Nerve Stimulation on Gastric Motility: A Preliminary Rode