01. June 2017 · Comments Off · Categories: Acupressure, Caesarean, Labour

Acupressure could have a role in reducing the rate of caesarean delivery and decreasing the duration of labour, according to Iranian authors. Meta-analysis of 13 studies showed that acupressure increased the chance of vaginal delivery when compared with placebo/no intervention. Acupressure was also found to decrease the duration of the active phase of labour by 1.3 hours and the second stage of labour by 5.8 minutes.
Meta-analysis of the effect of acupressure on duration of labor and mode of delivery. Int J Gynaecol Obstet. 2016 Oct;135(1):5-10.

01. October 2015 · Comments Off · Categories: Labour, Moxibustion, Pregnancy

Moxibustion at acupuncture point Zhiyin BL-67 can correct non-vertex presentation, reduce the number of caesarean sections performed and achieve cost savings for the healthcare system, compared with conventional treatment. Analysis by Spanish researchers showed that moxibustion prevents 8.92% of deliveries with non-vertex presentation compared with conventional treatment, resulting in an average cost saving of €107.11 per delivery (mainly due to the costs saved by avoiding the need for caesarean section). Analysis also showed an incremental cost per delivery ranging from €68 for moxibustion versus €640 for conventional treatment. (Cost effectiveness of using moxibustion to correct non-vertex presentation. Acupunct Med. 2015 Apr;33(2):136-41).

24. September 2015 · Comments Off · Categories: Acupuncture, Labour

A study carried out in Spain has shown that acupuncture at Qihai REN-6 can decrease the time taken for the placenta to be expelled after delivery. Seventy-six women who had experienced a normal birth were randomly assigned to receive verum acupuncture at Qihai REN-6 or sham acupuncture at a non-acupuncture point level with Qihai REN-6, but slightly to the left of the anterior midline. The management of the third stage of labour was otherwise the same in both groups. Statistically significant differences were found between the two groups, with an average time to placental expulsion of 15.2 minutes in the placebo group compared with 5.2 minutes in the acupuncture group. This has implications for maternal health since a prolonged third stage of labour is considered to be a risk factor for postpartum haemorrhage. (Influence of acupuncture on the third stage of labor: a randomized controlled trial. J Midwifery Womens Health. 2015 Mar;60(2):199-205).

A Brazilian group has shown that electro-acupuncture (EA) can be used to promote labour as efficiently as the prostaglandin analogue misoprostol, but with fewer obstetric complications. Sixty-seven pregnant women in labour were randomised to receive either EA or misoprostol. Women who received EA experienced significantly fewer obstetric complications, along with a significantly higher frequency of vaginal deliveries.  Although they tended to have a longer duration of labour, there was also a tendency to higher patient satisfaction among patients of the EA group. (Electroacupuncture for cervical ripening prior to labour induction: a randomized clinical trial. Arch Gynecol Obstet. 2011 Jun;283(6):1233-8).

Moxibustion at Sanyinjiao SP-6 may be able to markedly shorten the active phase of the first stage of labour and decrease pain due to uterine contractions, according to Taiwanese researchers. Sixty primipara women in labour were equally assigned, according to their choice, to three groups: bilateral moxibustion at Sanyinjiao SP-6 for 30 minutes, moxibustion at non-acupoints for 30 minutes and no moxibustion. The researchers found that the duration of the active phase of the first stage in the moxibustion group was significantly shorter than that in the other two groups. Visual analogue pain scores after moxibustion were also significantly lower in the this group compared with the no moxibustion group. (Effect of acupoint Sanyinjiao (SP6) moxibustion on the first stage of labor and uterine contractive pain in primiparae. Chin J Integr Med. 2011 Jun;17(6):464-6).

A Cochrane Database systematic review has concluded that acupuncture and acupressure may have a role in reducing pain, increasing satisfaction with pain management and reducing use of pharmacological management for women in labour. Thirteen trials with data on 1986 women were included. Nine trials reported on acupuncture and four on acupressure. Less intense pain was found with acupuncture compared with no intervention. One trial showed increased satisfaction with pain relief compared with placebo. Reduced use of pharmacological analgesia was found in one trial of acupuncture compared with placebo and one compared with standard care.  Fewer instrumental deliveries were found with acupuncture compared with standard care.  Pain intensity was reduced with acupressure, compared with placebo and control and a combined control.  Trials showed significant heterogeneity and all showed some risk of bias.  (Acupuncture or acupressure for pain management in labour.  Cochrane Database Syust Rev. 2011 Jul 6;(7):CD009232).

Danish clinicians carrying out the largest randomised controlled trial of acupuncture for relief of labour pain have found it to be a good supplement to existing pain relief methods, reducing the need for pharmacological and invasive methods during delivery. A randomised controlled trial was conducted with 607 healthy women in labour at term who received acupuncture, TENS, or traditional analgesics. Acupuncture was individualised, based on women’s mobility and localisation of pain, with points chosen from a list of 34 specified points. Although pain scores were comparable across the three groups, the use of pharmacological and invasive methods was significantly lower in the acupuncture group. Acupuncture did not influence the duration of labour or the use of oxytocin. In addition, indications of neonatal wellbeing (Apgar score and umbilical cord pH value) were significantly better among infants in the acupuncture group compared with infants in the other groups. (Acupuncture as pain relief during delivery: a randomized controlled trial. Birth. 2009 Mar;36(1):5-12).

Acupuncture significantly reduces duration of labour and reduces the need for augmentation of labour with contraction-stimulating drugs. A study randomised 100 women with spontaneous rupture of membranes at term to either acupuncture or no acupuncture. Treatment was individualised on the basis of traditional Chinese medical diagnosis and used three points per patient from a pool of nine possible choices. Treatment principles applied were to increase energy, soften the cervix and open the Conception vessel. Although time from membrane rupture to delivery did not differ significantly between the groups, length of active labour was significantly reduced in the acupuncture group by a mean difference of 1.7 hours. In addition, significantly fewer patients in the acupuncture group required oxytocin (used to stimulate contractions) for longer than two hours. Medical induction of labour was eventually necessary in 15 acupuncture patients and 20 controls. When induction was carried out, women assigned to acupuncture completed the active phase of labour in half the time compared to controls, a statistically significant difference. (Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin.

(A randomized controlled trial. Acta Obstet Gynecol Scand. 2006;85(11):1348-53)

Fifty-six primigravid women at 39 weeks or greater with a singleton gestation and Bishop score (a system for predicting whether induction of labour will be required) of less than seven were randomised to usual medical care or usual care plus three acupuncture treatments. Each treatment consisted of eight needles applied bilaterally to Hegu L.I.-4, Sanyinjiao SP-6, Shangliao BL-31 and Ciliao BL-32. Mean time from randomisation to delivery occurred 21 hours sooner in the acupuncture group, but this difference did not reach statistical significance. Compared with controls, women in the acupuncture group tended to be more likely to labour spontaneously and less likely to deliver by Caesarean section.

(A randomized controlled trial of acupuncture for initiation of labor in nulliparous women. J Matern Fetal Neonatal Med. 2006 Aug;19(8):465-70).