Document Detail


Moxibustion for correction of breech presentation: a randomized controlled trial.
MedLine Citation:
PMID:  9820259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Traditional Chinese medicine uses moxibustion (burning herbs to stimulate acupuncture points) of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of fetuses in breech presentation. Its effect may be through increasing fetal activity. However, no randomized controlled trial has evaluated the efficacy of this therapy.
OBJECTIVE: To evaluate the efficacy and safety of moxibustion on acupoint BL 67 to increase fetal activity and correct breech presentation.
DESIGN: Randomized, controlled, open clinical trial.
SETTING: Outpatient departments of the Women's Hospital of Jiangxi Province, Nanchang, and Jiujiang Women's and Children's Hospital in the People's Republic of China.
PATIENTS: Primigravidas in the 33rd week of gestation with normal pregnancy and an ultrasound diagnosis of breech presentation.
INTERVENTIONS: The 130 subjects randomized to the intervention group received stimulation of acupoint BL 67 by moxa (Japanese term for Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus persisted in the breech presentation. The 130 subjects randomized to the control group received routine care but no interventions for breech presentation. Subjects with persistent breech presentation after 2 weeks of treatment could undergo external cephalic version anytime between 35 weeks' gestation and delivery.
MAIN OUTCOME MEASURES: Fetal movements counted by the mother during 1 hour each day for 1 week; number of cephalic presentations during the 35th week and at delivery.
RESULTS: The intervention group experienced a mean of 48.45 fetal movements vs 35.35 in the control group (P<.001; 95% confidence interval [CI] for difference, 10.56-15.60). During the 35th week of gestation, 98 (75.4%) of 130 fetuses in the intervention group were cephalic vs 62 (47.7%) 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 (75.4%) of the 130 fetuses in the intervention group were cephalic at birth vs 81 (62.3%) of the 130 fetuses in the control group (P = .02; RR, 1.21; 95% CI, 1.02-1.43).
CONCLUSION: Among primigravidas with breech presentation during the 33rd week of gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery.
Authors:
F Cardini; H Weixin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA     Volume:  280     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-11-25     Completed Date:  1998-11-25     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1580-4     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score
Breech Presentation*
Delivery, Obstetric
Female
Fetal Movement
Humans
Infant, Newborn
Medicine, Chinese Traditional*
Moxibustion*
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Third
Comments/Corrections
Comment In:
JAMA. 1999 Oct 13;282(14):1329; author reply 1329-30   [PMID:  10527171 ]
JAMA. 1999 Oct 13;282(14):1329; author reply 1329-30   [PMID:  10527172 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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