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Overdue pregnancy? Labour induction with acupuncture


Labour induction with acupuncture

Induction of labour is a relatively common procedure. Sometimes labour can be induced at certain circumstances: for example, if your baby is overdue or there's any sort of risk to you or your baby's health. An induced labour is one that's started artificially. It's fairly common. Every year, 1 in 5 labours are induced in the UK. Some research data demonstrate that elective labour induction decreases the rate of still-birth without increasing the caesarean section rate. The induction is generally performed between 41 and 42 weeks according to the guidelines.

Acupuncture involves the insertion of very fine needles into designated locations with the purpose of preventing or curing disease. In TCM, it is thought that acupuncture stimulates channels of qi. This energy flows along 12 meridians, with designated points along these meridians. In Western medicine, it is thought that acupuncture may stimulate the release of prostaglandins and oxytocin. Acupuncture is used for induction of labour which is listed on WHO guideline. Recently a study from China analysed data from 2002 to 2008, sixty-five papers were retrieved. The results reveals that the research of acupuncture application in inducing labor focused on clinical practices, acupuncture has remarkable effectiveness and its advantages in facilitating contractions, shortening birth process, and elevating labor pain. A recent study has shown that absence of obstetric complication, higher duration of labor and tendency to a higher satisfaction of the patients were observed among patients in acupuncture group. There was also significantly higher frequency of vaginal deliveries and without occurrence of obstetric complications. Higher frequency of cesarean sections and obstetric complications were observed among patients in control group. A study from Astria has shown that the cervical length in the acupuncture group was shorter than that in the control group suggesting a cupuncture supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery.

Another study with 375 cases has shown that the women with acupuncture treatment experienced a higher rate of spontaneous onset of delivery compared to those without acupuncture. Prolonged pregnancy was lower in women receiving acupuncture compared to those without acupuncture. The oxytocin infusion rate was lower in the acupuncture group than in the control group. The rate of operative delivery is lower in women treated with acupuncture compared to controls. The possible mechanism is that acupuncture stimulates central oxytocin release and parasympathetic uterine activity increasing contractility; Acupuncture is softening the cervix and inducing uterine contractions to initial labour process.

Applications of acupuncture on delivery of baby in China

Acupuncture was used in introducing delivery of baby in ancient China. Is acupuncture still used in delivery today in China? Chen et al analysed research about acupuncture on delivery in past ten years from 2002 to 2012. They found that there are many clinical researches on five aspect of delivery including acupuncture for pain relief during delivery, acupuncture for the process of labor, acupuncture for the disorders of postpartum (such as postpartum uroschesis, postpartum abdominal pain, and insufficient lactation), acupuncture for abortion, and the influence of psychological factors in the pain relieving effects of acupuncture during delivery.

For pain relief during delivery, Interventions include body acupuncture, scalp acupuncture, acupressure, combination of auricular acupressure and body acupuncture, acupoint injection, and the combination of acupuncture or moxibustion with herbal or modern medicine. All researchers found that acupuncture can significantly relieve the pain during delivery, without adverse effects to both mother and child and they suggested that acupuncture may be an economic and convenient therapy in relieving pain during delivery.

For induction of labour or shortening the length of delivery, interventions include body acupuncture and acupressure. They found that that acupuncture can effectively reduce the duration of delivery (the whole length of delivery or second trimester of pregnancy), strengthen the uterine contraction, decrease the amount of oxytocin given during delivery, and significantly extend the length of uterine contraction and shorten the intermittent periods of contraction. No adverse event occurred.

A study compared acupuncture/acupressure with conventional methods to induce labour. The study group consisted of 50 women who received acupressure and/or Acupuncture prior to and/or during hospitalization. The control group consisted of 30 women who received customary hospital labor inducement methods. Result has shown that acupressure/Acupuncture significantly reduced additional interventions throughout the birth process, when these were given during hospitalization or before hospitalization. The birth process time was significantly shortened when combining acupressure/acupunture and conventional inducement methods (medicinal/mechanical). This study suggested that acupressure/acupuncture alone or combined with conventional methods is effective to reduce the extent of intervention throughout the birth process and also to reduce delivery completion interventions.

For disorders of postpartum period, the urine retention was focused on. The interventions include body acupuncture, combination of acupuncture and moxibustion, or herb or Guasha. Their finding was that either the single use of acupuncture or the combination of acupuncture and herbal medicine can relieve urine retention and achieve very high satisfaction. Meanwhile, studies of acupuncture in treating stress urinary incontinence, promoting recovery after cesarean section, treating abdominal pain, vaginal bleeding, and lactation difficulty of postpartum had satisfactory results.

Acupuncture is used for treatment of labour pain.

Acupuncture is an effective treatment for pain management. Acupuncture is also used for treating labour pain. Is there point specificity in labour pain treatment? Recently a study compared the effect of acupuncture with different acupuncture points on labour pain. In this study, Ex-B2 point and SP6 acupuncture points were chosen. Pain is assessed during active phase of labor before and 30, 60, 120 min after intervention. The duration of active phase, the duration of second stage of labor, the duration of third stage of labor, use of oxytocin, neonatal birth weight, neonatal Apgar score at 1 and 5 min. . After 30 min intervention, the mean VAS scores of both EX-B2 group and SP6 group were significantly decreased compared with the control group; however, no significant difference was observed between the two experimental groups. After 60 and 120 min intervention, the mean VAS scores of EX-B2 group were significantly lower than SP-6 group. Both EX-B2 group and SP6 group had significant lower VAS scores after interventions and shorter time used in active phase of labor than the control group. They suggested that the application of electro-acupuncture at EX-B2 and SP6 acupoints could be used as a non-pharmacologic method to reduce labor pain and shorten the duration of active phase of labor.

References

Chen and Zhu Zhongguo Zhen Jiu (2010) 30:877-80

Gribel et al Arch Gynecol Obstet (2011) 283:1233-8

Amir N et al Harefuah (2015) 154:47-51

Rabl M et al Wien Klin Wochenschr 92001) 113:942-6

Chen Y et al Evid Based Complement Alternat Med (2014) 2014:672508

Dong C et al Arch Gynecol Obstet (2014)

Neri I et al. J Acupunct Meridian Stud 2018 Jun 8. pii: S2005-2901(17)30196-6. doi: 10.1016/j.jams.2018.06.001. [Epub ahead of print]

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