Lectures

The research articles outlined below can be used to promote the use of acupuncture in pregnancy. Some like the articles on pelvic pain, nausea and vomiting and breech presentations have been selected for their publication in medical and midwifery journals readily accessible to medical professionals. Others such as the prebirth and cervical ripening articles are included as they represent the research available to date.

While clinical practice does not always reflect the methods used in research and questions remain over the use of methods such as a placebo in acupuncture, or the use of prescribed points rather than an individual diagnosis, western medical research does offer opportunities to discuss and promote acupuncture to medical professionals and the community. This is especially relevant in the area of obstetrics were safety and evidenced based practice are primary concerns.

Acupuncture and morning sickness

Smith et al in 2002 published two articles from their research on nausea and vomiting in pregnancy. The first looked at the effectiveness of acupuncture [5] and the second at the safety of acupuncture treatment in early pregnancy [6]

Summary

The objective was to compare; traditional acupuncture treatment, acupuncture at Neiguan P-6 only, sham acupuncture and no acupuncture treatment for nausea and vomiting. 593 women who were less than 14 weeks pregnant were randomised into 4 groups and received treatment weekly.

The acupuncture group, in which points were chosen according to a traditional acupuncture diagnosis, received two 20 minute acupuncture treatments in the first week followed by one weekly treatment for the next four weeks. The sham acupuncture group were needled at points close to but not on acupuncture points. Both the acupuncture group and the sham acupuncture group received their treatment from the same acupuncturist.

The outcomes of treatment were measured in terms of nausea, dry retching, vomiting and health status.

When compared to the women who received no treatment; the traditional acupuncture group reported less nausea throughout the study and less dry retching from the second week The Neiguan P-6 acupuncture group reported less nausea from the second week and less dry retching from the third week. The sham acupuncture group reported less nausea and dry retching from the third week.

So while all three acupuncture groups reported improvement with nausea and dry retching, it was the traditional acupuncture group that had the fastest response. Patients receiving traditional acupuncture also reported improvement in five aspects of general health status (vitality, social function, physical function, mental health and emotional role function) compared to improvement in two aspects with the Neiguan P-6 and Sham acupuncture groups. In the no treatment group there was improvement in only one aspect.

Although there were no differences in vomiting found in any of the treatment groups the authors speculated that more frequent treatments might have produced greater benefits.

In assessing the safety of acupuncture in early pregnancy data was collected on perinatal outcome, congenital abnormalities, pregnancy complications and the newborn. No differences were found between study groups in the incidence of these outcomes suggesting that there are no serious adverse effects from the use of acupuncture treatment in early pregnancy.

Conclusion

Acupuncture is a safe and effective treatment for women who experience nausea and dry retching in early pregnancy.

Acupuncture comments

Treatment method

The traditional acupuncture treatment involved the insertion of up to 6 needles per treatment. De qi was obtained and the needles left for 20 minutes. Points were selected according to the following pattern differentiation.

Liver qi stagnation: Taichong LIV-3, Neiguan P-6, Yanglingquan GB-34, Shangwan REN-13, Youmen KID-21, Lianqiu ST-34, Zusanli ST-36

Stomach or spleen deficiency: Zusanli ST-36, Neiguan P-6, Zhongwan REN-12

Stomach heat: Neiting ST-44, Jianli REN-11, Liangqiu ST-34, Liangmen ST-21, Neiguan P-6, Quze P-3

Phlegm: Fenglong ST-40, Yinlingquan SP-9, Burong ST-19, Pishu BL-20, Youmen KID-21 Heart qi deficiency: Tongli HE-5, Neiguan P-6, Zusanli ST-36, Juque REN-14

Heart fire: Neiguan P-6, Juque REN-14, Xinshu BL-15

Local abdominal points were also used, selecting from

ST-19, Chengman ST-20, Liangmen ST-21, Youmen KID-21, Futonggu KID-20, Juque REN-14, Shangwan REN-13, Zhongwan REN-12, Jianli REN-11 and Xiawan REN-10.

Clinical Perspective

This is a very interesting study, as it explores the use of traditional diagnostic patterns compared to the use of a point formulated treatment. In doing so it provides information both to acupuncturists and the western medical health professions about the most effective use of acupuncture. This reseach provides reassurance to the medical profession that acupuncture is a safe and effective treatment in early pregnancy as well as confirming the effectiveness of traditional diagnosis over using prescription point acupuncture.