Acupuncture and Moxibustion for Breech Presentation: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Mailan , LAN Lei , TANG Yong ,  LIANG Fanrong

Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;

Corresponding author：

LIANG Fanrong, Email: lfr@cdutcm.edu.cn

Keywords：

Breech presentation/acupuncture-moxibustion; Randomized controlled trial; Systematic review

DOI：

10.7507/1672-2531.20090148

Video：

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Objective 　To evaluate the efficacy of acupuncture and moxibustion (acup-moxi) therapy for breech presentation.
Methods 　We electronically searched The Cochrane Library (Issue 1, 2008), PubMed (1980 to Mar. 2008), MEDLINE (1966 to 2008), Ovid EBM Database (1991 to 2008), CBMdisc (1978 to Mar. 2008), VIP (1989 to Mar. 2008), CNKI (1979 to Mar. 2008), and WangFang Database (1983 to Mar. 2008), as well as handsearched seven traditional Chinese medicine journals to obtain randomized control trials (RCTs) about acup-moxi for breech presentation. Quality assessment was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Meta-analyses were performed for the results of homogeneous studies using RevMan 5.0 software.
Results 　Eight RCTs involving 1 341 patients met the inclusion criteria. Five trials were of relatively high quality and 3 were of low quality. The pooled analysis of six trials showed that acup-moxi was superior in cephalic presentation with RR=1.38, and 95%CI 1.20 to 1.58.
Conclusion 　Acup-moxi can increase the successful rate of cephalic presentation in the treatment of breech presentation compared with no (routine care) or knee-chest position treatment.

Citation： LIU Mailan,LAN Lei,TANG Yong,LIANG Fanrong. Acupuncture and Moxibustion for Breech Presentation: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(8): 840-843. doi: 10.7507/1672-2531.20090148 Copy

1.	Westgren M, Edvall H, Nordstrom L, et al. Spontaneous cephalic version of breech presentation in the last trimester. Br J Obstet Gynaecol, 1985, 92(1): 19-22.
2.	Cruikshank DP. Breech presentation. Clin Obstet Gynecol, 1986, 29(2): 255-263.
3.	《新编中华临床医药卫生全书》编委会编. 临床妇产科学. 中医古籍出版社, 2006. 225.
4.	Chen CH, Chou P, Hu HH, et al. Further analysis of a pilot study for planning an extensive clinical trial in traditional medicine with an example of acupuncture treatment for stroke. American Journal of Chinese Medicine, 1991, 22(2): 127.
5.	Johansson K, Lindgren I, Widner H, et al. Can sensory stimulation improve the functional outcome in stroke patients? Neurology, 1993, 43(11): 2189-2192.
6.	Coyle ME, Smith CA, Peat B. Cephalic version by moxibustion for breech presentation. Cochrane Database of Systematic Reviews 2005, Issue 2.
7.	Neri I, Airola G, Contu G, et al. Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study. Journal of Maternal-Fetal and Neonatal Medicine, 2004, 15(4): 247-252.
8.	Cardini F, Weixin H. Moxibustion for correction of breech presentation. JAMA, 1998, 280(18): 1580-1584.
9.	Li Q, Wang L. Clinical observation on correcting malposition of fetus by electro-acupuncture. Journal of Traditional Chinese Medicine, 1996, 16(4): 260-262.
10.	Managing Complications in Pregnancy and Childbirth: A guide formidwives and doctors. http://who.int/reproductive-health/impac/Symptoms/table_S12.html#S74%20Breech%20presentation.
11.	Higgins JPT, Green S, editors. Assessing risk of bias in included studies: Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 [updated September 2008], The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
12.	杨运宽, 茅敏, 胡幼平, 等．艾灸至阴穴矫治臀先露的多中心随机对照临床研究. 中医杂志, 2007, 48(12): 1097-1100.
13.	杨凤琴. 膝胸卧位配合艾灸至阴穴与单纯膝胸卧位纠正臀位的比较. 四川中医, 2006, 24(5): 106-107.
14.	Habek D, Cerkez Habek J, Jagust M. Acupuncture conversion of fetal breech presentation. Fetal Diagnosis And Therapy, 2003, 18(6): 418-421.
15.	Cardini F, Lombardo P, Regalia AL, et al. A randomised controlled trial of moxibustion for breech presentation. BJOG, 2005, 112(6): 743-747.
16.	杜艳华, 薛爱景. 中西医结合纠正臀先露50例临床观察. 现代中西医结合杂志, 2005, 14(20): 2727.
17.	Royal College of Obstetricians and Gynaecologists - Medical Specialty Society. The management of breech presentation. 2006 Dec. 13 pages. NGC:005915.
18.	Royal College of Obstetricians and Gynaecologists - Medical Specialty Society. External cephalic version and reducing the incidence of breech presentation.2006Dec.8pages. NGC:005918.
19.	National Government Agency [Non-U.S.].Caesarean section. National Collaborating Centre for Women’s and Children’s Health, 2004 Apr. 38 pages. NGC:003544.
20.	Hofmeyr GJ, Kulier R. Cephalic version by postural management for breech presentation. Cochrane Database of Systematic Reviews 2000, Issue 3.
21.	刘冠军. 现代针灸医案选. 北京: 人民卫生出版社, 1985. 350.
22.	刘喆. 古今妇科针灸妙法大成. 北京: 中国中医药出版社,1993. 179.
23.	王予康, 吕彪. 在B超监视下艾灸至阴穴矫正胎位66例. 针灸临床杂志, 2000, 16(4): 46-48.
24.	江西省艾灸矫正胎位研究协作组. 艾灸至阴穴矫正胎位的临床观察及原理探讨. 中医杂志, 1979, 20(8): 9.

1. Westgren M, Edvall H, Nordstrom L, et al. Spontaneous cephalic version of breech presentation in the last trimester. Br J Obstet Gynaecol, 1985, 92(1): 19-22.
2. Cruikshank DP. Breech presentation. Clin Obstet Gynecol, 1986, 29(2): 255-263.
3. 《新编中华临床医药卫生全书》编委会编. 临床妇产科学. 中医古籍出版社, 2006. 225.
4. Chen CH, Chou P, Hu HH, et al. Further analysis of a pilot study for planning an extensive clinical trial in traditional medicine with an example of acupuncture treatment for stroke. American Journal of Chinese Medicine, 1991, 22(2): 127.
5. Johansson K, Lindgren I, Widner H, et al. Can sensory stimulation improve the functional outcome in stroke patients? Neurology, 1993, 43(11): 2189-2192.
6. Coyle ME, Smith CA, Peat B. Cephalic version by moxibustion for breech presentation. Cochrane Database of Systematic Reviews 2005, Issue 2.
7. Neri I, Airola G, Contu G, et al. Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study. Journal of Maternal-Fetal and Neonatal Medicine, 2004, 15(4): 247-252.
8. Cardini F, Weixin H. Moxibustion for correction of breech presentation. JAMA, 1998, 280(18): 1580-1584.
9. Li Q, Wang L. Clinical observation on correcting malposition of fetus by electro-acupuncture. Journal of Traditional Chinese Medicine, 1996, 16(4): 260-262.
10. Managing Complications in Pregnancy and Childbirth: A guide formidwives and doctors. http://who.int/reproductive-health/impac/Symptoms/table_S12.html#S74%20Breech%20presentation.
11. Higgins JPT, Green S, editors. Assessing risk of bias in included studies: Cochrane Handbook for Systematic Reviews of Interventions 5.0.1 [updated September 2008], The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org.
12. 杨运宽, 茅敏, 胡幼平, 等．艾灸至阴穴矫治臀先露的多中心随机对照临床研究. 中医杂志, 2007, 48(12): 1097-1100.
13. 杨凤琴. 膝胸卧位配合艾灸至阴穴与单纯膝胸卧位纠正臀位的比较. 四川中医, 2006, 24(5): 106-107.
14. Habek D, Cerkez Habek J, Jagust M. Acupuncture conversion of fetal breech presentation. Fetal Diagnosis And Therapy, 2003, 18(6): 418-421.
15. Cardini F, Lombardo P, Regalia AL, et al. A randomised controlled trial of moxibustion for breech presentation. BJOG, 2005, 112(6): 743-747.
16. 杜艳华, 薛爱景. 中西医结合纠正臀先露50例临床观察. 现代中西医结合杂志, 2005, 14(20): 2727.
17. Royal College of Obstetricians and Gynaecologists - Medical Specialty Society. The management of breech presentation. 2006 Dec. 13 pages. NGC:005915.
18. Royal College of Obstetricians and Gynaecologists - Medical Specialty Society. External cephalic version and reducing the incidence of breech presentation.2006Dec.8pages. NGC:005918.
19. National Government Agency [Non-U.S.].Caesarean section. National Collaborating Centre for Women’s and Children’s Health, 2004 Apr. 38 pages. NGC:003544.
20. Hofmeyr GJ, Kulier R. Cephalic version by postural management for breech presentation. Cochrane Database of Systematic Reviews 2000, Issue 3.
21. 刘冠军. 现代针灸医案选. 北京: 人民卫生出版社, 1985. 350.
22. 刘喆. 古今妇科针灸妙法大成. 北京: 中国中医药出版社,1993. 179.
23. 王予康, 吕彪. 在B超监视下艾灸至阴穴矫正胎位66例. 针灸临床杂志, 2000, 16(4): 46-48.
24. 江西省艾灸矫正胎位研究协作组. 艾灸至阴穴矫正胎位的临床观察及原理探讨. 中医杂志, 1979, 20(8): 9.

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Acupuncture and Moxibustion for Breech Presentation: A Systematic Review

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