Research: RABL and colleagues, D

Listed in Issue 77

Abstract

RABL and colleagues, Department of Obstetrics and Gynecology, University of Vienna, Austria, michaela.rabl@akh-wien.ac.at, evaluated the effectiveness of acupuncture given at term to pregnant women to help induce labour and thus reduce the need for post-term induction.

Background

Methodology

This was a prospective, randomized, controlled (no treatment) clinical trial of acupuncture in 45 pregnant women who had a confirmed 'estimated date of confinement' (EDC) and an uncomplicated, single-foetus pregnancy with the foetus in the 'normal' head-down position (cephalic presentation) at term. Subjects were excluded from the study if they had cervical dilation greater than 3 cm, were in active labour, had premature rupture of membranes, a previous Caesarian section, or if they or the foetus had any abnormality or medical condition. On their EDC, the women were randomly assigned to either the acupuncture (ACU; n=25) or the control group (CON; n=20) . The ACU group received acupuncture at points Hegu (Large Intestine 4) and Sanyinjiao (Spleen 6) on both sides every second day after their respective EDC. All the subjects were examined every 2 days. Measurements taken included: cervical length (by vaginal ultrasound); foetal fibronectin test of cervical mucus; and cervical status according to the Bishop score. If subjects had not given birth by 10 days after their EDC, labour was induced by vaginal administration of prostaglandin tablets.

Results

In the ACU group, cervical length was significantly shorter on days 6 and 8 after the EDC in comparison with the CON group, the time period from the first positive foetal fibronectin test to delivery was shorter (2.3 days versus 4.2 days ), and the time from EDC to delivery was shorter (mean = 5.0 days versus 7.9 days ). Labour was induced in fewer women in the ACU group (n=5; 20%) than in the CON group (n=7; 35%), although the difference was not statistically significant. Oxytocin was used to augment labour in a smaller proportion of women in the ACU group (n=14; 56%) than in the CON group (n=13; 65%), although this difference was also not significant. There were no differences between groups in the overall duration of labour or in the durations of the first and second stages of labour.

Conclusion

Acupuncture applied bilaterally at points LI 4 and SP 6 in healthy pregnant women at term was able to encourage ripening of the cervix and reduce the time interval between the EDC and the actual time of delivery.

References

Rabl M et al. Acupuncture for cervical ripening and induction of labor at term – a randomized controlled trial. Wiener Klinische Wochenschrift 113 (23-24): 942-6. Dec 2001.

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