Pregnancy Research
Morning Sickness
Rosen, T. et al. “A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy.” Obstetrics and Gynecology. 2003 Jul;102(1):129-35.
A randomized controlled trial of 230 women with mild to severe nausea and vomiting between 6 and 12 weeks gestation participated in a 21 day trial. Patients receiving nerve stimulation at P6 had a significantly better score on the Rhodes Index of Nausea, Vomiting and Retching than patients in the control group (6.48 versus 4.65, P=0.2) Study patients also gained more weight than the control group (2.9 versus 1.2 lb, P=.003) The authors concluded that “nerve stimulation therapy is effective in reducing nausea and vomiting and promoting weight gain in symptomatic women in the first trimester.”
Smith, C. et al. “Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial.” Birth. 2002 March;29(1):1-9.
Single blind randomized controlled trail of 593 women less than 14 weeks pregnant with symptoms of nausea or vomiting. The women were randomized into 4 groups: traditional acupuncture, acupuncture at P6 only, sham acupuncture, or no acupuncture (control). Treatment was administered for 4 weeks. Women in all three treatment groups experienced less nausea and dry retching than the control group, though the fastest results were seen for patients receiving traditional acupuncture (traditional acupuncture group: nausea p<0.01 and dry retching p<0.01) Data was also collected on perinatal outcomes, congenital abnormalities and pregnancy complications and the newborn. No differences were found between the 4 groups in the incidence of these outcomes. The authors concluded “Acupuncture is an effective treatment for women who experience nausea and dry retching in early pregnancy. A time-related placebo effect was found for some women.”
Pelvic Girdle Pain
Elden, H. et al. “Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial.” British Medical Journal. 2005 Apr 2;330(7494):761.
This study compared the efficacy of standard physiotherapy treatment, standard physiotherapy treatment plus acupuncture, and standard physiotherapy treatment plus stabilizing exercises for pregnant women suffering from pelvic pain. 125 women received acupuncture twice a week for 6 weeks. The authors concluded, “Acupuncture and stabilising exercises constitute efficient complements to standard treatment for the management of pelvic girdle pain during pregnancy. Acupuncture was superior to stabilising exercises in this study.”
Breech Presentation
Cardini, F, et al. “Moxibustion for correction of breech presentation: a randomized controlled trial.” Journal of the American Medical Association. 1998 Nov 11;280 (18):1580-4.
This study was designed to evaluate the efficacy and safety of moxibustion on an acupoint at the tip of the little toe to increase fetal activity and correct breech presentation. During the 35th week of gestation, 98 of 130 fetuses in the intervention group were cephalic vs 62 of 130 fetuses in the control group (P<.001; relative risk [RR], 1.58; 95% CI, 1.29-1.94). Despite the fact that 24 subjects in the control group and 1 subject in the intervention group underwent external cephalic version, 98 of the 130 fetuses in the intervention group were cephalic at birth vs 81 of the 130 fetuses in the control group (P = .02; RR, 1.21; 95% CI, 1.02-1.43) The authors concluded, “Moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery.” There were no adverse events in the moxibustion group, and premature births were lower in the moxibustion group.
Pain Management during Labor
Smith, C.A. et al. “Complementary and alternative therapies for pain management in labour.” Cochrane Database System Review. 2006 Oct 18; (4): CD003521.
This meta-analysis included a number of different complementary and alternative therapies, including three acupuncture studies (N=496) and two acupressure studies (N=172). The acupuncture trials showed a decreased need for pain relief (Relative risk 0.70, 95% confidence interval 0.49 to 1.00, two trials 288 women). The authors concluded that “acupuncture may be helpful for pain relief during labor, but the number of women studied has been small.”
Nesheim, BI et al. “Acupuncture during labor can reduce the use of meperidine: a controlled clinical study.” Clinical Journal of Pain. 2003 May-Jun;19(3):187-91.
This randomized, unblinded, controlled study consisted of 290 parturients at term, 106 of whom received acupuncture. The outcome measure for effectiveness of acupuncture was the required use of meperidine. Meperidine was given to 11% of the acupuncture group, 37% of the no acupuncture group, and 29% of the control group. The use of other analgesics was also lower in the acupuncture group. Patient satisfaction in the acupuncture group was high; 89 out of 103 patients asked said they would want acupuncture during another labor.
Lee, MK et al. “Effects of SP6 acupressure on labor pain and length of delivery time in women during labor.” Journal of Alternative and Complementary Medicine. 2004 Dec;10(6):959-65.
This study involved 75 women in labor, assigned to either a Sp6 acupressure or Sp6 touch control group. Participants were matched according to parity, cervical dilation, labor stage, rupture of amniotic membrane and husband.s presence during labor. No oxytocin or analgesics were administered during the test period. Labor pain was measured before intervention, after the intervention, and 30 and 60 minutes after the intervention. Length of delivery time was calculated in two stages: from 3cm cervical dilation to full cervical dilation, and full cervical dilation to the delivery. There were significant differences between the two groups in labor pain at all time points following the intervention (immediately after p=0.012, 30 minutes after p=0.021 60 minutes after p=0.012) Total labor time was shorter in the Sp6 acupressure group (p=0.006)
Ingram, J et al. “The effects of shiatsu on post-term pregnancy.” Complementary Therapies in Medicine. 2005 March;13(1):11-5.
This study involved women at 40 weeks gestation who all attended the same outpatient clinic. Sixty-six women were taught acupressure and another 76 women were not. More women in the acupressure group (17%) went into labor naturally.
Chung, UL et al. “Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor.” Journal of Nursing Research. 2003 December;11(4):251-60.
In this study, 127 women were randomly assigned to receive either acupressure, light touch or no treatment during labor. Data was collected from subjective labor pain scores and external fetal monitoring strips. The authors found significant difference in labor pain among the acupressure group, confirming the effect of acupressure in lessening labor pain during the active phase of the first stage of labor.
Prebirth Acupuncture
Betts, Debra et al. “Acupuncture for Prebirth Treatment: An Observational Study of its Uses in Midwifery Practice.” Medical Acupuncture. 2006 May; 10(3).
This observational study included the practices of 14 midwives practicing in New Zealand over a 4-month period, and included 169 women who received .prebirth acupuncture.. Women received 4 treatments beginning in the 37th week of pregnancy. Midwives used a variety of acupoints that included prebirth protocol points plus other points specific to the woman.s condition. The mean labor time for primigravidas was 9 hours. The mean labor time for multigravidas was 4.7 hours. The midwives included in this study observed the following results: a 35% reduction in the number of inductions (43% reduction for primigravida women), 31% reduction in epidural rate, 32% reduction in emergency cesarean delivery and a 9% increase in normal vaginal birth.