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

Maite Miranda-Garcia,Cristina Domingo Gómez,M Dolores Gómez Roig,Josefina Goberna-Tricas,Betina Nishishinya,Cristina Molinet-Coll,Ikram Allaoui

doi:10.1155/2019/7036914

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.

Highlights

Breech presentation at the time of delivery is 3.8–4%
A meta-analysis showed no difference in the rate of cesareans between the treatment and control groups (RR 1.05, 95% CI 0.87 to 1.26), but the results of this meta-analysis should be considered with caution, due to clinical heterogeneity
0.25, 95% CI 0.09 to 0.72) e combination of acupuncture and moxibustion is effective for cephalic version at birth (RR 0.73, 95% CI 0.57 to 0.94) and has fewer cesarean births (RR 0.79, 95% CI: 0.64 to 0.98) Moxibustion combined with postural techniques resulted in fewer noncephalic presentations at birth (RR 0.26, 95% CI 0.12–0.56)

Summary

Introduction

Breech presentation at the time of delivery is 3.8–4%. To review the evidence from systematic reviews (SR) on the efficacy and safety of acupuncture and moxibustion in pregnant women with noncephalic presentation. Our SR synthesizes the results from five clinical trials on pregnant women with a singleton noncephalic presentation. Ere is evidence that moxibustion reduces the number of noncephalic presentations at the time of birth compared with no treatment. E adverse effects that acupuncture and moxibustion can cause seem to be irrelevant. 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

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Conclusion