Obstetric Acupuncture Research Articles

The application of acupuncture in obstetrics and gynecology: a bibliometric analysis based on Web of Science.

Acupuncture therapy has a wide range of applications in obstetrics and gynecology, especially for patients with reproductive issues, irregular menstruation, dysmenorrhea, and pelvic inflammatory disease. In recent decades, acupuncture therapy has gradually attracted the attention of professionals in China and overseas due to its beneficial effects, and has been the focus of many studies. This study aimed to conduct a statistical analysis of the relevant literature to understand the current application and research status of acupuncture in obstetric and gynecologic diseases. A search of the SCI-EXPANDED database in the Web of Science Core Collection (WOSCC) was performed. Search strategy included two formulas: #1 WC=Obstetrics & Gynecology, limited: index =SCI-EXPANDED time span=all years; #2 subject: (ACUPUNCTURE-MOXIBUSTION) OR subject: (ACUPUNCTURE) OR subject: (MOXIBUSTION), limited: index=SCI-EXPANDED time span=all years. The final result was acquired by searching #1 AND #2. CiteSpace software was used to analyze and visualize the annual distribution of articles, and the distributions of disciplines, countries/institutions, journals, and authors. Keywords were used to infer the application of acupuncture in obstetrics and gynecology. A total of 593 research literatures, including 323 original articles, were retrieved. Since 1972, the number of literatures has shown a general increase. Studies on reproductive medicine accounted for the highest proportion of the retrieved literatures (139, 23.44%). The United States (25.5%), China (14.0%), Germany (7.6%), Australia (7.3%), and Sweden (7.1%) were the main contributors. The centrality index showed that the United States (0.19), the United Kingdom (0.19), and Germany (0.16) had the closest cooperation. The retrieved literatures covered 15 subdivision areas, including menstruation, embryo transfer, production, and pelvic pain. Obstetrics & Gynecology, Cochrane Database of Systematic Reviews, and American Journal of Obstetrics and Gynecology were found to be the most influential journals. The most frequently cited keywords were acupuncture (intensity =5.5326), low back pain (intensity =5.0506), and pregnancy (intensity =4.7016). Acupuncture is receiving an increasing amount of attention in obstetrics and gynecology, and international cooperation in research in this field is also increasing.

A review of acupuncture in obstetrics and gynaecology

Key content Acupuncture is an ancient form of medicine involving sensory stimulation via needle insertion. In the UK, Western medical acupuncture (WMA), an adaptation of traditional Chinese approach, is used in varying circumstances, including in obstetrics and gynaecology. Outcome studies have demonstrated that acupuncture can be effective in pain management, fertility and obstetrics (during pregnancy, intrapartum and postpartum). Acupuncture is safe and has a very low risk of adverse incidents if carried out by trained and accredited practitioners. Learning objectives To understand that there is a different but complementary option available when treatment success is not achieved with Western medicine and that women may opt for acupuncture over more recognised treatment options. To be aware that studies have shown that acupuncture can be a beneficial treatment, but most studies are non‐randomised. Ethical issues Women should be given information about all suitable treatments, including acupuncture, to make an informed choice.

Acupuncture in Obstetrics and Gynecology

Importance Acupuncture is a key component of therapy in traditional Chinese medicine. Only in the last few decades has acupuncture become popular in the United States. The mechanism behind acupuncture's effects on the body and brain has not been completely elucidated, but there is evidence that acupuncture has effects on the endocrine, immune, and sympathetic and parasympathetic nervous systems. It may also act through electrical and mechanical signaling through the connective tissue and fascia. Despite this uncertainty, the positive effects of acupuncture have been well established. Objective In this review, we discuss the basic concepts of traditional Chinese medicine and acupuncture and examine the evidence regarding the use of acupuncture in obstetrics and gynecology. Evidence Acquisition We conducted a literature review of acupuncture in obstetrics and gynecology using PubMed. Results The available data demonstrate that acupuncture is beneficial in the treatment of labor pain, back pain in pregnancy, and dysmenorrhea. It is unclear if acupuncture is effective for hyperemesis, chemotherapy-induced nausea and vomiting, and menopausal hot flushes, or if moxibustion is effective in correcting breech presentation. There are limited but positive data regarding menopause-related sleep disturbances, depression in pregnancy, and overactive bladder. Acupuncture is not beneficial for improving outcomes in in vitro fertilization. Conclusions and Relevance Acupuncture is an increasingly popular therapy with many potential applications in obstetrics and gynecology. A general understanding of the basic principles of acupuncture and the safety and efficacy of its practice is necessary for the general obstetrician and gynecologist to make informed recommendations to patients. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to identify the basic concepts of traditional Chinese medicine and how it differs from Western medicine; describe common obstetrical and gynecologic issues that can be successfully treated with acupuncture; and distinguish the main issues in designing acupuncture studies regarding blinding, choosing a control group, and identifying areas of potential bias.

"Pregnancy Brain": A Review of Cognitive Changes in Pregnancy and Postpartum.

The idea that pregnant women suffer from deficits in memory is widespread but poorly documented in obstetrical literature. To review available psychology literature on the subject of cognitive changes in pregnancy in order to guide the prenatal care provider on how to counsel pregnant women. An extensive review of PubMed and PsycINFO databases was conducted to gather and analyze relevant studies on cognitive changes in pregnancy. A large body of literature examining basic science and animal studies support the effects of pregnancy hormones in remodeling brain architecture and neural function. However, studies in humans are hampered by small sizes, heterogeneous methodology, and varying definitions of memory. Nevertheless, the consensus among researchers is that pregnancy does confer deficits in working memory relative to nonpregnant controls. Cognitive effects of pregnancy are likely small, and the impact on daily life is debatable. Further research is needed to determine whether these effects may confer an advantage to parous women comparable to that seen in lower mammals.

La seguridad de la acupuntura obstétrica: los puntos prohibidos revaluados

Background/aimAlthough the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be ‘forbidden’ during pregnancy. This article reviews the scientific literature on this topic. Main findingsThere is no objective evidence of harm following needling at forbidden points, summarised by the following four lines of evidence. (1) In 15 clinical trials (n=823 women receiving n=4549-7234 acupuncture treatments at one or more forbidden points) rates of preterm birth (PTB) and stillbirth following are equivalent to those in untreated control groups and consistent with background rates of these complications in the general population. (2) Observational studies, including a large cohort of 5885 pregnant women needled at forbidden points at all stage of pregnancy, demonstrate that rates of miscarriage, PTB, preterm prelabour rupture of membranes (PPROM), and preterm contractions (preterm labour (PTL) or threatened PTL) are comparable with untreated controls and/or consistent with their anticipated incidence. (3) There is no reliable evidence that acupuncture/electroacupuncture (EA) can induce miscarriage/labour, even under otherwise favourable circumstances such as post-dates pregnancy or intrauterine fetal death. (4) Laboratory experiments using pregnant rats have demonstrated that repeated EA at forbidden points throughout gestation does not influence rates of post-implantation embryonic demise or cause miscarriage, fetal loss or resorption. ConclusionsThese findings are reassuring and will help individualised risk:benefit assessment before treating pregnant women. Given the numerous evidence-based indications for obstetric acupuncture and lack of evidence of harm, risk:benefit assessments will often fall in favour of treatment.

The safety of obstetric acupuncture: forbidden points revisited.

Background/aimAlthough the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be ‘forbidden’ during pregnancy. This article reviews the scientific literature on this topic.Main findingsThere is no objective evidence of harm following needling at forbidden points, summarised by the following four lines of evidence. (1) In 15 clinical trials (n=823 women receiving n=4549–7234 acupuncture treatments at one or more forbidden points) rates of preterm birth (PTB) and stillbirth following are equivalent to those in untreated control groups and consistent with background rates of these complications in the general population. (2) Observational studies, including a large cohort of 5885 pregnant women needled at forbidden points at all stage of pregnancy, demonstrate that rates of miscarriage, PTB, preterm prelabour rupture of membranes (PPROM), and preterm contractions (preterm labour (PTL) or threatened PTL) are comparable with untreated controls and/or consistent with their anticipated incidence. (3) There is no reliable evidence that acupuncture/electroacupuncture (EA) can induce miscarriage/labour, even under otherwise favourable circumstances such as post-dates pregnancy or intrauterine fetal death. (4) Laboratory experiments using pregnant rats have demonstrated that repeated EA at forbidden points throughout gestation does not influence rates of post-implantation embryonic demise or cause miscarriage, fetal loss or resorption.ConclusionsThese findings are reassuring and will help individualised risk:benefit assessment before treating pregnant women. Given the numerous evidence-based indications for obstetric acupuncture and lack of evidence of harm, risk:benefit assessments will often fall in favour of treatment.

Patient expectations of acupuncture in pregnancy.

Background:Expectations for treatment have been associated with outcomes. Expectations in acupuncture treatment have rarely been addressed, and due to the unique concerns of pregnancy and childbirth, obstetric patients merit special attention.Primary Study Objective:Assess treatment expectations of acupuncture clinic patients treated for obstetric and related concerns.Methods/Design:Descriptive follow-up involving a patient-completed survey; chief treatment concern and number of treatment sessions were validated against patient records.Participants:Of 265 former clinic patients, 137 (51.7%) completed the internet survey.Main Outcome Measures:Self-reported demographic variables; responses to open-ended questions on treatment expectations; general treatment variables.Results:Using standard qualitative data analytic strategies, we identified five major treatment expectations, for example, affecting labor and delivery, benefiting the whole system, and treating specific symptoms.Limitations:Retrospective method and recall bias may have influenced reported expectations.Conclusion:Obstetric acupuncture patients' expectations overlap with other subgroups in terms of symptom treatment. They also indicate a distinct interest in taking an active role in childbirth and in replacing conventional interventions, warranting further inquiry into obstetric acupuncture effects and safety in childbearing women.

Acupuncture in Pregnancy

Acupuncture is an excellent tool for the treatment of various conditions during pregnancy. As a non-pharmacological method, it is ideally suited to this delicate time period in a woman's life. Indeed one of its main advantages is arguably the avoidance of unnecessary medication, the potential harms of which are exemplified by the devastation caused by thalidomide, which was of course originally introduced as a treatment for pregnancy-associated nausea and vomiting. Acupuncture may be used antenatally, for labour and delivery, and even during the postnatal period. Given the lack of any evidence of harm following acupuncture treatment during pregnancy,1 which is further highlighted by the accompanying paper by Carr,2 the aim of this editorial is to provide an overview of the current indications for obstetric acupuncture, to share my personal experience in this area, and to offer some practical suggestions for treatment. Much of the acceptance of acupuncture within the scientific community is due to pioneering work that demonstrated its effectiveness for the treatment of nausea and vomiting. While most well-designed studies have focused on chemotherapy-induced or postoperative nausea and vomiting, there is evidence that acupuncture can also be effective in pregnancy-associated nausea and vomiting across the spectrum from morning sickness to hyperemesis gravidarum.3 Around the time of delivery, it has been shown to be effective as a complementary or alternative technique for intrapartum analgesia,4 and acupuncture and/or moxibustion at BL67 is often used to promote cephalic version in breech presentation,5 ,6 typically between 33 and 35 weeks’ gestation. Acupuncture and related techniques may also be used to increase the …

Characteristics of a U.S. Obstetric Acupuncture Clinic Patient Sample

Most U.S.-based studies on acupuncture treatment for obstetric concerns published in mainstream health journals have been randomized controlled trials, widely considered the "gold standard" for clinical research. However, whether those studies adequately reflect the characteristics and treatment concerns of actual treatment users is as yet unknown. Provide a reference point for advancing U.S. obstetric acupuncture research by (1) describing background and relevant treatment characteristics of an obstetric acupuncture clinic sample and (2) reviewing those characteristics in relationship to existing U.S.-based studies. Descriptive follow-up involving a patient-completed internet survey; chief treatment concern and number of treatment sessions were validated against patient records. Of 265 former clinic patients, 137 (51.7%) completed the internet survey. Patient referral source and demographics; primary and secondary treatment concerns; number of treatment sessions; and planned birth attendant and setting. The clinic sample's demographics generally aligned with those in existing U.S. studies. However, the chief concern of most clinic patients was labor facilitation compared to two of the seven U.S.-based publications. Clinic patients learned about acupuncture through midwives and family/friends; 28% planned out-of-hospital birth. This first study on a U.S. obstetric acupuncture clinic sample suggests that an obstetric acupuncture research agenda relevant to current treatment users should increase focus on labor facilitation, involve samples from a wider range of maternal care settings, and continue outreach to ethnic minorities.

Patient-reported benefits of acupuncture in pregnancy

As U.S. expenditures on acupuncture treatment rise, so does the need to examine specific acupuncture patient subpopulations because their treatment needs and goals vary. This study focused on treatment benefits reported by former obstetric acupuncture patients, which addresses a critical research gap on subjective patient experiences. Of 265 former clinic patients, 137 (51.7%) completed an internet survey with an open-ended question on treatment benefits. Using standard qualitative analytic strategies, we identified five major themes related to benefits, including, for example, treated chief concerns, helped achieve a desired birth experience, and provided holistic benefit. Identified themes and subthemes spoke to benefits of acupuncture on specific pregnancy symptoms and on the birth process. Clinical and research implications for identified themes, including those related to the birth process and birth setting, are discussed.

Acupuncture for the induction of labour: a double-blind randomised controlled study

Sir, Robert Fraser1 finds our effort to conduct a randomised controlled trial on acupuncture for the induction of labour a waste of energy. His argument is based only on a quotation from 2002 by Dr Renckens.2 We therefore find another quotation from the same issue of BJOG appropriate, this one by Dr Zeisler and Dr Husslein.3 It states that, ‘acupuncture in obstetrics is drug-free, clinically effective and cost-effective’. Furthermore, the recent conclusion by Dr Smith and Dr Cochrane4 justifies further studies on acupuncture. It states that, ‘evidence is beginning to consolidate that acupuncture may assist with the management of some complaints during pregnancy. However, definitive conclusions about its effectiveness cannot be reached and further research is therefore justified.’

Acupuncture in Obstetrics and Gynecology: An Overview of Systematic Reviews

Acupuncture is often recommended for obstetrical and gynecological conditions but the evidence is confusing. We aim to summarize all recent systematic reviews in this area. Western and Asian electronic databases were searched for systematic reviews of any type of acupuncture for any type of gynecological conditions. Our own files were hand-searched. Systematic reviews of any type of acupuncture for any type of gynecological conditions were included. Non-systematic reviews and systematic reviews published before 2004 were excluded. No language restrictions were applied. Data were extracted according to predefined criteria and analysed narratively. Twenty-four systematic reviews were included. They relate to a wide range of gynecological conditions: hot flashes, conception, dysmenorrhea, premenstrual syndrome, nausea/vomiting, breech presentation, back pain during pregnancy, and procedural pain. Nine systematic reviews arrived with clearly positive conclusions; however, there were many contradictions and caveats. The evidence for acupuncture as a treatment of obstetrical and gynecological conditions remains limited.

Acupuncture for Birth Preparation and Delivery: How Investigating Mechanisms of Action Can Generate Research

Acupuncture has become an accepted and validated part of Western mainstream medicine and is increasingly used by clinicians, midwives, and acupuncturists for reproductive care, induction of labor, and analgesia. Most studies of the effects of obstetrical acupuncture are descriptive, many in foreign languages. Only a few have evaluated efficacy. Results suggest that acupuncture ripens the cervix, initiates labor, reduces labor pain, and shortens the first stage of labor. There is some evidence suggesting that certain acupuncture points have very specific effects on the fetus and uterus, which may be mediated through the hypopituitary-thalamic axis or by local neurovascular stimulation. The substantial maternal hormonal changes occurring just before and during labor offer a unique opportunity to clarify the mechanisms of action of acupuncture. Using a conceptual model based on possible mechanisms of action of the use of acupuncture in obstetrics, the authors propose specific research questions into the physiology of acupuncture administered before and at parturition.

The sharp end of medical practice: the use of acupuncture in obstetrics and gynaecology

The sharp end of medical practice: the use of acupuncture in obstetrics and gynaecology

The sharp end of medical practice: the use of acupuncture in obstetrics and gynaecology

The sharp end of medical practice: the use of acupuncture in obstetrics and gynaecology

Acupuncture in obstetrics

The attention of obstetricians and gynecologists to the method of reflexotherapy is attracted by the possibility of reducing the pharmacological load on the body of the pregnant woman and the fetus, the absence of unwanted side effects when used properly. Reflexotherapy can also be the method of choice in the presence of intolerance to a number of pharmacological compounds. Reflexotherapy improves protective properties of organism, has normalizing effect on tone and reactivity of vegetative section of nervous system, normalizes activity of endocrine glands, in particular, sex glands, regulates tone of muscles. It is proved that this method significantly influences hypothalamic-pituitary-adrenal system of the organism.