Cephalic version by moxibustion for breech presentation

Systematic Reviews to Inform Practice, September/October 2023

“…Providers should continue to consider moxibustion use as a strategy for achieving cephalic presentation before offering ECV to patients. Additionally, evidence on the safety of moxibustion is consistent across past and more recent studies, but providers must ensure that full informed consent is obtained and proper education is given to patients planning to self‐administer moxibustion at home for facilitating a cephalic presentation 4 . ‐ 6 …”

“…During pregnancy, the moxibustion has been studied for its use in managing breech presentation. Breech presentation occurs in 3% to 4% of pregnancies and is associated with elevated risk for fetal deoxygenation, knee and hip dysplasias, prolonged labor, instrument‐assisted birth, and cesarean birth 3 , 4 . As a result of these risks and decreased opportunities to learn safe management of breech birth, perinatal care providers take measures to achieve cephalic position prior to labor and birth.…”

“…Moxibustion involves burning of the Chinese herb Artemisia in the form of bunches or sticks and applied to the acupuncture point Bladder 67, which is located at the tip of the fifth toe 3 , 4 . Based on previous studies, Schlaeger et al recommended a self‐administered protocol of daily 30‐minute applications beginning at 34 to 35 weeks’ gestation for a minimum of 10 days, but this has not been tested 3 .…”

“…The mechanism of action is theorized to be related to stimulation of uterine contractions which, in turn, stimulate fetal activity that facilitates turning into a cephalic presentation. However, the exact mechanisms have not been determined 4 …”

“…Coyle et al 4 conducted an updated review of studies examining the effectiveness and safety of moxibustion to correct breech presentation including the new evidence that has been published since the last Cochrane systematic review in 2012. The final analysis included 13 studies consisting of 2181 participants; sample sizes ranged from 14 to 406 participants (median, 162).…”