Acupuncture in the obstetric clinic: Efficacy and safety analysis

• Witre Omar Padilla National University Toribio Rodríguez de Mendoza de Amazonas (UNTRM-A), Chachapoyas, Peru. http://orcid.org/0000-0003-2957-5038
• Manuel Emilio Milla Pino National University of Jaén (UNJ), Jaén, Peru http://orcid.org/0000-0003-3931-9804
• River Chávez Santos National University Toribio Rodríguez de Mendoza de Amazonas (UNTRM-A), Chachapoyas, Peru. http://orcid.org/0000-0001-7946-2846

DOI: https://doi.org/10.46925//rdluz.33.26

Keywords: Acupuncture; effectiveness; security; obstetrics

Abstract

The present study is a systematic review of the scientific works on the efficacy and safety of acupuncture in the most frequent clinical conditions in obstetrics. Clinical trials, systematic reviews and meta-analyzes available until September 2020 were included. The strength of the evidence according to the quality of the studies, for the efficacy of acupuncture, was located in three groups. Those for nausea and vomiting of pregnancy, back pain, and labor pain are in the first group. For the other conditions, further research or better designed studies are needed to draw definitive conclusions. Regarding safety, the quality of reports of acupuncture adverse effects was found to be poor, although their incidence appears to be low and of mild to moderate severity compared to conventional treatments.

References

Allais, G; Chiarle, G; Sinigaglia, S; Airola, G; Schiapparelli, P; Bergandi1, F & Benedetto, C. (2019). Acupuncture treatment of migraine, nausea, and vomiting in pregnancy. Neurological Sciences. 40 (1): S213–S215 https://doi.org/10.1007/s10072-019-03799-2

Betts, D & Budds, S. (2011). ‘Forbidden points’ in pregnancy: historical wisdom? Acupunct Med 2011; 29:137–139. DOI:10.1136/aim.2010.003814

Birch S. (2001). Systematic reviews of acupuncture—Are there problems with these? Clin Acupunct Orient Med. 2:17–22

Birch, S; Hesselink, J. K; Fokke, A.M; Jonkman; Thecla, A.M; Hekker, M.D; & Aat, B. (2004). Clinical Research On Acupuncture: Part 1. What Have Reviews of the Efficacy and Safety of Acupuncture Told Us So Far? The Journal of Alternative and Complementary Medicine. 10 (3):468–480

Bishop, A; Ogollah, R; Bartlam, B; Barlas, P; Holden, M. A; M. Ismail, K. M; Jowett, S; Lewis, L. M; Lloyd, A; Kettle, C; Kigozi, J; Foster, N. E & the EASE Back study team. (2016). Evaluating acupuncture and standard care for pregnant women with back pain: the EASE Back pilot randomised controlled trial. DOI 10.1186/s40814-016-0107-6

Boelig, R. C; Barton, S. J; Saccone, G; Kelly, A.J; Edwards, S. J & Berghella, V. (2016). Interventions for treating hyperemesis gravidarum. Cochrane Database Syst Rev. (5):CD010607. DOI: 10.1002 / 14651858.CD010607.pub2

Brici, P; Franconi, G; Scatassa, C; Fabbri, E and Assirelli, P. (2019). Turning Foetal Breech Presentation at 32-35 Weeks of Gestational Age by Acupuncture and Moxibustion. Hindawi Evidence-Based Complementary and Alternative Medicine Volume Article ID 8950924, 5 pages https://doi.org/10.1155/2019/8950924

Carr, D & Lythgoe, J. (2014). Use of acupuncture during labour. The Practising Midwife. 17(5): 12-5

Chen, R; Li, Z & Liang, Ji. (2020). The Effect of the Full-time Nursing Staff Accompanying to Elderly Parturients Combined with Percutaneous Electrical Stimulation. Journal of Gynecology and Obstetrics. 8(1): 16-19. http://www.sciencepublishinggroup.com/j/jgo DOI: 10.11648/j.jgo.20200801.14

Cho, S-H; Lee, H; & Ernst, E. (2010). Acupuncture for pain relief in labour: a systematic review and meta-analysis. BJOG An International Journal of Obstetrics and Gynaecology. 907-920. DOI: 10.1111/j.1471-0528.2010.02570.x

Clarkson C. E; O’mahony, D & Jones, D. E. (2015). Adverse event reporting in studies of penetrating acupuncture during pregnancy: a systematic review. Acta Obstet Gynecol Scand; 94: 453–464. DOI: 10.1111/aogs.12587

Coulon, C; Poleszczuk, M, Paty-Montaigne, M.H; Gascard, C; Gay, C; HoufflinDebarge, V & Subtil, D. (2014). Version of breech fetuses by moxibustion with acupuncture: a randomized controlled trial. Obstet Gynecol. 124 (1):32–9. DOI: 10.1097 / AOG.0000000000000303

Coyle, M.E; Smith; C.A & Peat, B. (2012). Cephalic version by moxibustion for breech presentation. Cochrane Database Syst Rev. (5):CD003928. DOI: 10.1002 / 14651858.CD003928.pub3.

Enblom, A & Johnsson, A. (2017). Type and frequency of side effects during PC6 acupuncture: observations from therapists and patients participating in clinical efficacy trials of acupuncture. Acupunct Med 2017. 35:421–429. doi:10.1136/acupmed-2016-011270

Gillerman, K; Kulkarni, A; Shah, A; Gudi, A & Homburg, R. (2018). The impact of acupuncture on IVF success rates: A randomised controlled trial. Fertil Sci Res. 5 (2):48-54. DOI: 10.4103 / fsr.fsr_37_18

Guerreiro da Silva, J. B. (2015). Acupuncture in pregnancy. Acupunct Med. 33:350–352. DOI:10.1136/acupmed-2015-010938

Guven, P.G; Cayir Y & Borekci, B. (2020). Effectiveness of acupuncture on pregnancy success rates for women undergoing in vitro fertilization: A randomized controlled trial. Taiwan J Obstet Gynecol. 2020 Mar;59(2):282-286. doi: 10.1016/j.tjog.2020.01.018. PMID: 32127151.

Jang, S; Kim, K. H; Jun, J. H & You, S. (2020). Acupuncture for in vitro fertilization in women with poor ovarian response: a systematic review. Integrative Medicine Research. 9 100395. DOI: 10.1016 / j.imr.2020.02.003

Jiaying, L; Ying, H; Ning, Z; Bing, W; Yu, Z; Deli, Y; Guirong, Z; Ying, W & Junfeng, P. (2008). The Safety of Electroacupuncture at Hegu (LI 4) plus Oxytocin for Hastening Uterine Contraction of Puerperants: A Randomized Controlled Clinical Observation. Journal of Traditional Chinese Medicine. 28(3): 163-167

Karim, F; Dilley, J & Cheung, E. (2019). A review of acupuncture in obstetrics and gynaecology. The Obstetrician & Gynaecologist 21:209–14. DOI: 10.1111/tog.12574

Kusuma, A. C; Oktari, N; Mihardja, H; Srilestari, A; Simadibrata, C. L; Hestiantoro, A; Wiweko, B; & Muna, N. (2019). Electroacupuncture Enhances Number of Mature Oocytes and Fertility Rates for In Vitro Fertilization. Medical Acupuncture. 31(5). DOI: 10.1089/acu.2019.1368

Lim, C. E. D; Wilkinson, J; Wong, W. S. F; & Cheng, N. C. L. (2009). Effect of Acupuncture on Induction of Labor. The Journal Of Alternative and Complementary Medicine. 15 (11): 1209–1214. DOI: 10.1089=acm.2009.0100

Maa, W., Bai, W., Lin, C., Zhou, P., Xia, L., Zhao, C., Hao, Y., Maa, H., Liu, X., Wang, J., Yuan, H., Xie, Y & Lu, A. (2011). Effects of Sanyinjiao (SP6) with electroacupuncture on labour pain in women during labour. Complementary therapies in medicine 19: S13-S18. DOI: 10.1016/j.ctim.2010.09.001

Macpherson, H; Altman, D.G; Hammerschlag, R; Youping, L; Taixiang, W; White, A 6 Mother, D. (2010). Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med. 7:100–6https://doi.org/10.1371/journal.pmed.1000261

Maged, A. M; Hassanin, M. E; Kamal, W. M; Abbassy, A. H; Alalfy, M; Askalani, A. N; El-Lithy, A; Nabil, M; Farouk, D; Hussein, E. A & Hammad, B. (2019). Effect of Low-Level Laser Therapy versus Electroacupuncture on Postnatal Scanty Milk Secretion: A Randomized Controlled Trial. DOI https://doi.org/ 10.1055/s-0039-1693428

Moon, H-Y, Kim, M-r; Hwang, D-S; Jang, J-B; Lee, J; Shin, J-S; Ha, I & Lee, Y. J. (2020). Safety of acupuncture during pregnancy: a retrospective cohort study in Korea. BJOG. 127:79–87. DOI: 10.1111/1471-0528.15925

Nauta, B. A. (2016). The Use of Electroacupuncture for Cervical Ripening in Pregnant Women. Tesis para optar al grado de Doctor of Philosophy en la Universidad de Nebraska, USA. 58 pp. https://digitalcommons.unmc.edu/etd/161

Park, J; Sohn, Y; White, A. R; & Lee, H. (2014). The safety of acupuncture during pregnancy: a systematic review. Acupunct Med. 32:257–266. DOI:10.1136/acupmed-2013-010480

Pearl, D & Schillinger, E. (1999). Acupuncture: its use in medicine. Western Journal of Medicine. 171 (3): 176-180

Qian, Y; Xia, X. R; Ochin, H; Huang, C; Gao, C; Gao, L; Cu, Y. G; Liu, J. Y & Meng, Y. (2016). Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis. Arch Gynecol Obstet. DOI 10.1007/s00404-016-4255-y

Qu, F & Zhou, J. (2007). Electro-Acupuncture in Relieving Labor Pain. eCAM; 4(1)125–130 DOI:10.1093/ecam/nel05

Qu, F; Wang, F. F; Wu, Y; Zhou, J; Robinson, R; Hardiman, P. J; Pan, J. X; He, Y. J; Zhu, Y. H; Wang, H. Z; Ye, X. Q; He, K. L; Cui, L; Zhao, H. L & Ye, Y. H. (2015).Transcutaneous Electrical Acupoint Stimulation Improves The Outcomes Of In Vitro Fertilization: A Prospective, Randomized And Controlled Study, Explore: The Journal of Science and Healing, http://dx.doi.org/10.1016/j.explore.2017.06.004

Raihanah, S; Djamil, M & Jati, S. P. (2020). Moxibustion for nausea and vomiting in pregnancy. JKKI 2020;11(1): 67-72. DOI: 10.20885/JKKI.Vol11.Iss1.art10

Saleem, A; Chadha, W. M; Prakash, A & Aggarwal, S. (2015). A comparison of ondansetron and P6 point acupuncture stimulation in prevention of carboprost induced nausea and vomiting in patients undergoing cesarean section under subarachnoid block. Anaesth, Pain & Intensive Care. 19(1): 24-7

Salehi, A; Marzban, M & Imanieh, M. H. (2016). The Evaluation of Curative Effect of Acupuncture: A Review of Systematic and Meta-Analysis Studies. Journal of Evidence-Based Complementary & Alternative Medicine. 21(3): 202-214. DOI: 10.1177/2156587215598422

Sandoval Paredes, J & Sandoval Paz, C. (2018). Uso de fármacos durante el embarazo. Horiz. Med. 18 (2): http://dx.doi.org/10.24265/horizmed.2018.v18n2.11

Shen, C; Wu, M; Shu, D; Zhao, X & Gao, Y. (2015). The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest. 79:1–12. DOI: 10.1159/000362231

Sierpina, V. S & Frenkel, M. A. (2005). Acupuncture: A Clinical Review. Southern Medical Journal. 98 (3): 330-7

Silva Martins, E; Barbosa Castro, C. M; Alves Rocha, L. M & Bezerra Pinheiro, A. K. (2017). Acupuncture and pregnancy: oriental medicine as an ally in the treatment of low back pain. Rev Rene. 18(4):551-8. DOI: 10.15253/2175-6783.2017000400018

Silva Martins, E; Lopes Tavares, T. M. C; Amorim Lessa; P. R; de Souza Aquino; P; Barbosa Castro; R. C. M & Bezerra Pinheiro; A. K. (2018). Acupuncture treatment: multidimensional assessment of low back pain in pregnant women. Rev Esc Enferm USP .52:e03323. DOI: http://dx.doi.org/10.1590/S1980-220X2017040303323

Smith, C. A & Crowther, C. A. (2004). Acupuncture for induction of labour. Cochrane Database of Systematic Reviews. 1. DOI: 10.1002/14651858.CD002962.pub2

Smith, C. A; Crowther, C. A & Grant S.J. (2013). Acupuncture for induction of labour. Cochrane Database of Systematic Reviews. Issue 8. Art. No.: CD002962. DOI: 10.1002/14651858.CD002962.pub3.

Smith, C.A., Armour, M & Dahlen, H.G. (2017). Acupuncture or acupressure for induction of labour. Cochrane Database Systematic Reviews. DOI: 10.1002 / 14651858.CD002962.pub4

Smith, C & Dahlen, H. (2009). Caring for the pregnant woman and her baby in a changing maternity service environment: the role of acupuncture. Acupuncture in Medicine. 27(3): 123-125. https://doi.org/10.1136/aim.2009.001115

Smith, C. A; de Lacey, S; Chapman, M; Ratcliffe, J; Norman, R. J; Johnson, N. P; Boothroyd, C & Fahey, P. (2018). Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization A Randomized Clinical Trial. JAMA. 319(19):1990-1998. DOI:10.1001/jama.2018.5336

Soliday, E & Debra Betts, D. (2018). Treating Pain in Pregnancy with Acupuncture: Observational Study Results from a Free Clinic in New Zealand. J Acupunct. Meridian stud. 11 (1): 25-30. https://doi.org/10.1016/j.jams.2017.11.005

Tara, F., Bahrami-Taghanaki, H., Amini Ghalandarabad, M., Zand-Kargar, Z., Azizi, H. y Esmaily, H. (2020). The Effect of Acupressure on the Severity of Nausea, Vomiting, and Retching in Pregnant Women: A Randomized Controlled Trial. Complementary Medicine Research. 27 (4). DOI: 10.1159 / 000505637

World Health Organization. Acupuncture: Review and Analysis Reports on Controlled Clinical Trials. Geneva, Switzerland: World Health Organization; 2002.

Wu, H. C; Liu, Y. C; Ou, K. L; Chang Y. H; Hsieh, C. L; Tsai, A. H-C; Tsai, H-T; Chiu, T-H; Hung, C-J; Lee, C-C & Lin, J-g. (2009). Effects of acupuncture on post-cesarean section pain. Chinese Medical Journal 2009;122(15):1743-1748

Xie, Zy., Peng, Zh., Yao, B; Chen, L; Mu, Y. Y; Cheng, J; Li, Q; Luo, X; Yang, P. Y & Xia, Y. (2019). The effects of acupuncture on pregnancy outcomes of in vitro fertilization: a systematic review and meta-analysis. BMC Complement Altern. Med 19, 131. https://doi.org/10.1186/s12906-019-2523-7

Yao, X; Li, C; Ge1, X; Wei, J; Luo, J; Li, F &Tian, F. (2017). Effect of acupuncture on pregnancy related low back pain and pelvic pain: a systematic review and meta-analysis. Int J Clin Exp Med. 10(4):5903-5912. DOI: 10.1186 / s12906-019-2523-7