Does Acupuncture Have a Place as an Adjunct Treatment During Pregnancy? A Review of Randomized Controlled Trials and Systematic Reviews

Caroline A. Smith, PhD, MSc, BS (Hons), LicAc, and Suzanne Cochrane, BSocialWork, DipTraditionalChineseMedicine, 2009

https://doi.org/10.1111/j.1523-536X.2009.00329.x

Breech Presentation Use of Moxibustion

Moxibustion (a type of Chinese medicine therapy that involves burning a herb close to the skin) to the acupuncture point Bladder 67 (BL67; Chinese name Zhiyin), located at the tip of the fifth toe, has been proposed as a way of correcting breech presentation. The use of moxibustion has been evaluated in two systematic reviews, both of which suggest preliminary evidence of a reduction in breech presentation (12,13). The latest review, which includes the most recently published trials, included six randomized controlled trials and three cohort studies with a control group (12). Overall, fewer breech presentations were found at the end of the intervention. For the cohort studies, breech presentation in the intervention group was 15 percent (n = 347) versus 36 percent in the control group (n =459; OR 0.29, 95% CI 0.19–0.43). For the pooled randomized controlled trials, a significant effect from moxibustion was found; the proportion of breech presentations in the intervention group was 34 percent versus 66 percent in the control group (OR 0.25, 95% CI 0.11–0.58). The Cochrane review did not combine data in a meta-analysis from trials described as heterogeneous. The review reported that moxibustion reduced the need for external cephalic version (RR 0.47, 95% CI 0.33–0.66) (13). The methodological scores were high for both reviews, although critical appraisal of studies was limited in the review of van den Berg et al (12). Both reviews concluded that the current literature shows a beneficial effect from using acupuncture-type interventions on acupuncture point BL67 to induce correction of a breech presentation compared with expectant management, but further high-quality studies are needed.