Acupuncture Administered After Spontaneous Rupture of Membranes at Term Significantly Reduces the Length of Birth and Use of Oxytocin: A Randomized Controlled Trial

Abstract

The major risk of prelabor rupture of membranes (PROM) at term is ascending intrauterine infection. Because acupuncture is a relatively safe procedure that supports the natural birthing process, a randomized, controlled trial was planned to identify the effects of acupuncture—if any—on the progress of labor and on its outcome. Forty-three women with spontaneous PROM were assigned to undergo acupuncture while 48 others served as a control group. Thin, sterile, stainless steel needles were used for acupuncture at three points in all patients with the goals of increasing energy, softening the cervix, and opening the “conception vessel” meridian. In all, nine acupuncture points were used. Treatment was individualized using pulse and tongue diagnosis and the principles of traditional Chinese medicine. Treatment lasted about 20 minutes. Labor was induced if it did not occur spontaneously within about 24 hours after PROM. Induction employed either oxytocin infusion or vaginal prostaglandin administration as guided by the Bishop score. No significant difference was found between the acupuncture and control groups in the time from PROM to delivery, but women given acupuncture had a significantly shorter duration of labor. The active phase of labor averaged approximately 4½ hours in acupuncture patients and 6 hours in control women. Birth weights did not differ significantly. Nearly one-third of women in each group received epidural analgesia. Significantly fewer acupuncture patients required oxytocin for longer than 2 hours, and this difference remained significant after multiple logistic regression analysis to control for potentially confounding factors. Conventional induction was necessary in 15 acupuncture patients and 20 control women. When induction was carried out, women assigned to acupuncture completed the active phase of labor in half the time as in control women, a statistically significant difference. The difference in numbers of instrumental deliveries (13 in the control group and 6 in the acupuncture group) was not significant. No adverse effects of acupuncture were recognized. Acupuncture appears to be a useful addition or, in some cases, alternative to conventional pharmacological induction of labor in women with PROM.