Moxibustion for cephalic version: a feasibility randomised controlled trial
ABSTRACT Moxibustion (a type of Chinese medicine which involves burning a herb close to the skin) has been used to correct a breech presentation. Evidence of effectiveness and safety from systematic reviews is encouraging although significant heterogeneity has been found among trials. We assessed the feasibility of conducting a randomised controlled trial of moxibustion plus usual care compared with usual care to promote cephalic version in women with a breech presentation, and examined the views of women and health care providers towards implementing a trial within an Australian context.
The study was undertaken at a public hospital in Newcastle, New South Wales, Australia. Women at 34-36.5 weeks of gestation with a singleton breech presentation (confirmed by ultrasound), were randomised to moxibustion plus usual care or usual care alone. The intervention was administered over 10 days. Clinical outcomes included cephalic presentation at birth, the need for ECV, mode of birth; perinatal morbidity and mortality, and maternal complications. Feasibility outcomes included: recruitment rate, acceptability, compliance and a sample size for a future study. Interviews were conducted with 19 midwives and obstetricians to examine the acceptability of moxibustion, and views on the trial.
Twenty women were randomised to the trial. Fifty one percent of women approached accepted randomisation to the trial. A trend towards an increase in cephalic version at delivery (RR 5.0; 95% CI 0.7-35.5) was found for women receiving moxibustion compared with usual care. There was also a trend towards greater success with version following ECV. Two babies were admitted to the neonatal unit from the moxibustion group. Compliance with the moxibustion protocol was acceptable with no reported side effects. Clinicians expressed the need for research to establish the safety and efficacy of moxibustion, and support for the intervention was given to increase women's choices, and explore opportunities to normalise birth. The sample size for a future trial is estimated to be 381 women.
Our findings should be interpreted with caution as the study was underpowered to detect statistical differences between groups. Acceptance by women and health professionals towards moxibustion suggest further research is warranted.
Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000985280.
Full-textDOI: · Available from: Hannah Dahlen, May 28, 2015
SourceAvailable from: Francisco Rivas-Ruiz[Show abstract] [Hide abstract]
ABSTRACT: Objective To compare the effectiveness of additional moxibustion at point BL 67 with moxibustion at a non-specific acupuncture point and with usual care alone to correct non-vertex presentation. Methods This was a multicentre randomised controlled trial in which 406 low-risk pregnant women with a fetus in ultrasound breech presentation, with a gestational age of 33-35 weeks, were assigned to: a) true moxibustión at point BL 67 plus usual care; b) moxibustion at SP 1, a non-specific acupuncture point (sham moxibustion) plus usual care; or c) usual care alone. The primary outcome was cephalic presentation at birth. Women were recruited at health centres in primary healthcare. Results In the true moxibustion group, 58.1% of the full-term presentations were cephalic compared with 43.4% in the sham moxibustion group (relative risk [RR]: 1.34; 95% confidence interval [95%CI], 1.05-1.70) and 44.8% of those in the usual care group (RR: 1.29; 95%CI, 1.02-1.64). The reduction in RR of the primary outcome in women allocated to the true moxibustion group compared with the usual care group was 29.7% (95%CI, 3.1-55.2) and the number needed to treat was 8 (95%CI, 4-72). There were no severe adverse effects during the treatment. Conclusions Moxibustion at acupuncture point BL 67 is effective and safe to correct non-vertex presentation when used between 33 and 35 weeks of gestation. We believe that moxibustion represents a treatment option that should be considered to achieve version of the non-vertex fetus.Revista Internacional de Acupuntura 06/2014; 8(2):41–49. DOI:10.1016/S1887-8369(14)70113-9
EXPLORE The Journal of Science and Healing 05/2014; 10(3):198-202. DOI:10.1016/j.explore.2014.02.011 · 0.94 Impact Factor
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ABSTRACT: For thousands of years, moxibustion has been used for various diseases in China and other Asian countries. Despite the recent surge in Chinese herbal studies, few randomized controlled trials have been conducted on this modality, possibly due to the lacking of suitable double blinding methodology. This is a review of extant sham moxa devices and an introduction to a recently developed device that needs further validation.05/2014; 12(3):131-134. DOI:10.1016/S2095-4964(14)60024-8