|Articles|October 1, 2003

Altmed Watch

 

ALTMED WATCH
The latest research on complementary and alternative medicine

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Should acupuncture play a role in pregnancy management?

As with most complementary/alternative therapies, there are no large-scale randomized trials that conclusively prove acupuncture can alleviate labor pain, relieve morning sickness, induce labor, or help resolve a breech presentation. But there are a few tantalizing hints to suggest that it may have some therapeutic value.1

A small, randomized trial that divided 100 women between acupuncture and no acupuncture groups found that the treatment reduced the need for epidural analgesia by 22%, compared to 12% in the control group (RR = 0.52, 95% CI 0.3–0.92.) While the acupuncture group did not say the intensity of their pain was any less, they reported they were more relaxed. The therapy had no adverse effects, i.e., rates of instrumental vaginal deliveries and C-sections didn't differ, duration of labor was about the same, there were no 1- or 5-minute Apgar scores below 7, and there were no differences in the need for oxytocin.2

In a single-blind trial that compared acupuncture to a sham procedure, women reported significantly less pain and need for analgesics. They also spent less time in active labor, with no evidence that the procedure had adverse effects on labor or hospital stay.3

The research on labor induction is not as well controlled. One observational study has found that the median duration of first-stage labor was 196 minutes in an acupuncture group and 321 minutes in a control group.4 Similarly, 85% of the control group required oxytocin in the first stage, versus 15% (72% vs. 28% in second-stage labor). Two open clinical trials also concluded that acupuncture increased the intensity of labor contractions and reduced time to delivery.1

1. Tamayo C. Acupuncture and pregnancy. Altern Ther Women's Health. 2003;5:41-46.

2. Ramnero A, Hanson U, Kihlgren M. Acupuncture treatment during labour—a randomized controlled trial. BJOG. 2002;109:637-644.

3. Skilnand E, Fossen D, Heiberg E. Acupuncture in the management of pain in labor. Acta Obstet Gynecol Scand. 2002;81:943-948.

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