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Acupuncture for induction of labour

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Abstract

Background

This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. The use of complementary therapies is increasing and some women look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. The limited observational studies to date suggest acupuncture for induction of labour appears safe, has no known teratogenic effects, and may be effective. The evidence regarding the clinical effectiveness of this technique is limited.

Objectives

To determine the effects of acupuncture for third trimester cervical ripening or induction of labour.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2008), the Cochrane Complementary Medicine Field's Trials Register (The Cochrane Library 2007, Issue 4), AMED (1985 to November 2007), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2007), Dissertation Abstracts (1861 to November 2007), CINAHL (1982 to November 2007), the UK National Research Register, (November 2007) and the Australian Clinical Trials Registry (November 2007) and bibliographies of relevant papers. We updated the search of the Pregnancy and Childbirth Group’s Trials Register on 23 May 2012 and added the results to the awaiting classification section of the review

Selection criteria

Clinical trials comparing acupuncture used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods.

Data collection and analysis

A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two‐stage method of data extraction.

Main results

Three trials (212 women) were included in the review.  Fewer women receiving acupuncture required use of induction methods (RR 1.45, 95% CI 1.08 to 1.95) compared with standard care (147 women, relative risk 1.45, 95% confidence interval 1.08 to 1.95). There were no differences between groups in the reporting of other outcomes.

Authors' conclusions

There is a need for well‐designed randomised controlled trials to evaluate the role of acupuncture to induce labour and for trials to assess clinically meaningful outcomes.

[Note: the 15 citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Acupuncture for induction of labour

There is insufficient evidence describing the efficacy of acupuncture to induce labour.

Induction of labour (getting labour started artificially) is common when the pregnancy is posing a greater risk to the pregnant woman or her unborn child. Acupuncture is the insertion of fine needles into specific energy points of the body and has been used to help induce labour and reduce labour pains. The review included three trials involving 212 women. The evidence regarding the clinical effectiveness of this technique is limited, although small studies suggest women receiving acupuncture compared to standard obstetric care received fewer methods of induction. More research is needed.