Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang, Qinhong; Yue, Jin; Liu, Ming; Sun, Zhongren; Sun, Qi; Han, Chao; Wang, Di

doi:10.1155/2013/241027

Cited by 18 publications

(30 citation statements)

References 19 publications

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“…Bladder 67 (BL67) Well known for its use for version of breech to a cephalic presentation. [45][46][47] Together with LI4 it is used to reduce labor pain. 34 It also stimulates uterine contractions.…”

Section: Figurementioning

confidence: 99%

Acupuncture and Acupressure in Labor

Schlaeger¹,

Gabzdyl²,

Bussell³

et al. 2016

J Midwife Womens Health

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Acupuncture and acupressure, 2 modalities of Traditional Chinese Medicine, are based on reducing pain and symptoms of disease through balancing yin and yang. Acupuncture and acupressure have been used in China for reduction of labor pain, labor augmentation, and other intrapartum indications for more than 2 millennia. This article presents a review of the current literature that has addressed the effects of acupuncture and acupressure on intrapartum events. Studies of acupuncture have demonstrated that acupuncture may reduce labor pain, the use of pharmacologic agents, the use of forceps and vacuum-assisted births, and the length of labor. Studies that examined the effect of acupuncture on labor that is induced or augmented for premature rupture of membranes have found that acupuncture may increase the degree of cervical ripening but does not reduce the amount of oxytocin or epidural analgesia administration, nor does it shorten length of induced labor. Acupressure may reduce labor pain and labor duration, but acupressure has not been found to increase cervical ripening or induce labor. There are insufficient studies about acupuncture and acupressure and their effects on labor at this time, and there is need for further research. Areas of uncertainty include efficacy, optimal point selection, best techniques, and length of time for point stimulation.

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Section: Figurementioning

confidence: 99%

Acupuncture and Acupressure in Labor

Schlaeger¹,

Gabzdyl²,

Bussell³

et al. 2016

J Midwife Womens Health

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show abstract

“…Exclusion criteria were as follows: history of prior uterine surgery, uterine abnormalities, multiple pregnancy, contraindications to vaginal delivery, maternal cardiovascular disease, severe hypertension, American Society of Anesthesiologists class >2, allergy to the trial medications, prelabor ruptured membranes, placental abruption, fetal anomaly, intrauterine fetal death, and fetal weight above 3800 g. In addition, participants who received ECV, and also the moxibustion therapy, [2] to correct the BP before the study recruitment were also excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Several interventions can help correct BP, such as moxibustion. [2] In addition, external cephalic version (ECV) can also change a fetal presentation from breech to cephalic by external pressure exerted through the maternal abdominal wall by the obstetrician. The American College of Obstetricians and Gynecologists (ACOG) has proposed the use of ECV to reposition the fetus to a cephalic presentation in an attempt to avoid caesarean delivery.…”

Section: Introductionmentioning

confidence: 99%

A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

Liu¹,

Xue

2016

Medicine

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Background:Although external cephalic version (ECV) can be effective for correcting the fetus in a cephalic presentation, it may be painful for the mother. This study aimed to evaluate the efficacy and safety of remifentanil for pain relief during ECV in China.Methods:In all, 152 Chinese parturients with singleton breech presentation were randomly divided into 2 groups, each with 76 patients. All 152 patients were assigned to receive either remifentanil (infused at 0.1 μg/kg/min and demand boluses of 0.1 μg/kg) or saline placebo. The study was performed between January 2012 and December 2015. Outcome measurements included the Numerical Rating Pain Scale score (0–10) after ECV, success rate for ECV, and maternal satisfaction after ECV. Adverse events were also evaluated.Results:The study was completed by 146 patients. Remifentanil showed greater efficacy than placebo in decreasing the pain score immediately after ECV (remifentanil 4.6 ± 2.6 vs placebo 6.5 ± 2.7; P < 0.001). The success rate for ECV showed a significant difference between the 2 groups (remifentanil 56.5% vs placebo 39.5%; P = 0.04). Maternal satisfaction also showed a significant difference between the 2 groups (remifentanil 9.6 ± 1.4 vs placebo 6.4 ± 3.7; P < 0.001). However, the adverse events profiles were similar between both groups.Conclusion:The results of this study demonstrate that remifentanil is an effective intervention for reducing pain, achieving successful ECV, and increasing maternal satisfaction during ECV, and is generally well-tolerated without additional adverse effects.

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“…Only moxibustion has been studied in placebo-controlled randomized trials; however, all of these techniques are considered to be safe and pose no maternal or fetal risks. [38][39][40][41][42] Postural techniques to turn a breech have been used for many years. 41,43 The classic tilt technique pictured in Ina May Gaskin's Spiritual Midwifery 43 is probably the most widely recognized posture.…”

Section: Nonconventional Version Techniquesmentioning

confidence: 99%

“…39 However, the Zhang meta-analysis included high-quality RCTs that were published after the Cochrane review. 42 One of these trials was published in 2013 by Vas et al and included 406 women from 58 primary health care centers in Spain. 45 Pregnant women between 33 weeks' and 35 weeks' gestation were randomized to receive true moxibustion, sham moxibustion, or usual care.…”

Section: Nonconventional Version Techniquesmentioning

confidence: 99%

Vaginal Breech Birth: Can We Move Beyond the Term Breech Trial?

Hunter¹

2014

J Midwife Womens Health

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Since the publication of the Term Breech Trial in 2000, planned cesarean has become the preferred mode of birth for women whose fetus is in a breech presentation. Over the past 20 years, however, subsequent evidence has not shown conclusively that cesarean birth is safer than vaginal birth for a fetus in a breech presentation when certain criteria are met. Many obstetric organizations support the option of planned vaginal birth for women with a breech presentation under strict prelabor selection criteria and intrapartum management guidelines. The growing trend toward cesarean unfortunately has left midwives and other intrapartum care providers in training with dwindling opportunities to competently master skills for vaginal breech birth. Although simulation training offers opportunities to practice infrequently encountered skills such as vaginal breech birth, it is unknown if this alternative will provide sufficient experience for future generations of clinicians. As a result, women with a breech presentation at term who desire a trial of labor often have limited choices. This article reviews the controversies surrounding the ideal mode of birth created by the Term Breech Trial. Criteria for vaginal breech birth are summarized and the role of simulation explored. Implications for midwifery practice when a breech presentation is diagnosed are also included.

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Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 18 publications

References 19 publications

Acupuncture and Acupressure in Labor

Acupuncture and Acupressure in Labor

A randomized trial of remifentanil for analgesia in external cephalic version for breech presentation

Vaginal Breech Birth: Can We Move Beyond the Term Breech Trial?

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