Effectiveness and Safety of Acupuncture and Moxibustion in Pregnant Women with Noncephalic Presentation: An Overview of Systematic Reviews

Abstract

Background Breech presentation at the time of delivery is 3.8–4%. Fetuses that maintain a noncephalic presentation beyond 32 weeks will have a lower probability of spontaneous version before labor. Given the increasing interest in exploring the use of complementary medicine during pregnancy and childbirth, the moxibustion technique, a type of traditional Chinese medicine, could be another option to try turning a breech baby into a cephalic presentation. Objectives To review the evidence from systematic reviews (SR) on the efficacy and safety of acupuncture and moxibustion in pregnant women with noncephalic presentation. Main Results Our SR synthesizes the results from five clinical trials on pregnant women with a singleton noncephalic presentation. There is evidence that moxibustion reduces the number of noncephalic presentations at the time of birth compared with no treatment. The adverse effects that acupuncture and moxibustion can cause seem to be irrelevant. Most SRs agree that there are no adverse effects directly related to acupuncture and moxibustion. Conclusions Even though the results obtained are positive and the five reviews conclude that moxibustion reduces the number of noncephalic presentations at birth (alone or combined with postural techniques or acupuncture), there is considerable heterogeneity between them. Better methodologically designed studies are required in the future to reaffirm this conclusion.

Effectiveness of Moxibustion for Breech Presentation: A Prospective Study

“…On the other hand, the meta-analysis did not include the findings of another study conducted with a high number of participants reporting the positive effect of moxibustion 20 42 . More recent reviews including a greater number of studies concluded that moxibustion is an effective method for changing fetal presentation from breech to vertex 43 44 .…”

“…Preterm contractions and rupture of membranes are being investigated by several researchers. There have been only a few cases diagnosed with these complications after moxibustion 43 . In our study, we also showed that the preterm delivery rate is similar between groups.…”

Complementary and Alternative Medicine for Threatened Miscarriage: Advantages and Risks

“…e moxa was placed over the acupoints Zusanli (ST36), Neiguan (P6), and Mingmen (GV4), and the combination approach was superior to progesterone or dydrogesterone alone in decreasing the miscarriage rate in women with threatened miscarriage [118,119] (Table 3). In contrast, it has been reported that moxibustion can stimulate estrogen and prostaglandin production and increase fetal activity and uterine contractions in order to reduce noncephalic presentations at birth [120]. us, the safety and efficacy of moxibustion in the treatment of threatened miscarriage are still a matter of debate.…”

Cephalic version by postural management in the lateral position without the knee‐chest position for primiparous breech presentation: A retrospective cohort study

“…However, there is little research evidence to support these other methods' effectiveness. [14][15][16][17][18][19][20] Postural management methods for breech presentation includes the knee-chest position (genupectoral position) and the Indian version (supine position with the elevated pelvis). In Japan, the lateral position (the right lateral recumbent position if the fetal back is on the left side of the maternal body or the left lateral recumbent position if the fetal back is on the right side of the maternal body, shown in Figure 1) is traditionally performed in combination with the kneechest position for breech presentation.…”

“…Other methods for breech presentation include postural management, acupuncture, and moxibustion. However, there is little research evidence to support these other methods' effectiveness 14–20 . Postural management methods for breech presentation includes the knee‐chest position (genupectoral position) and the Indian version (supine position with the elevated pelvis).…”