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FACT
Focus on Alternative and Complementary Therapies

Effectiveness of acupuncture-type interventions to resolve breech presentation compared to expectative policy, a meta-analysis

van den Berg I1, Jacobs B2, Bouman I2, Bosch JL1,3, Hunink MGM1,3
1Department of Epidemiology and Biostatistics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
2Stichting Rotterdamse Opleiding tot Verloskundige (the Rotterdam Institution for Training Midwives), Rotterdam, The Netherlands
3Department of Radiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands

Objective

To assess the effect of acupuncture-type interventions (acupoint-moxibustion, acupuncture and electro-acupuncture) to resolve breech presentation compared to expectative policy.

Materials and methods

Studies between 1980 and April 2005 were identified by searching databases of Medline, the Cochrane Central Register of Controlled Trials and Midirs. Studies were included if an acupuncture-type intervention of acupoint Bl 67 was compared with expectative policy and when the following criteria were described: confirmation of presentation with ultrasound and one of the following measures: position of child after treatment, position of child at delivery and treatment time. Three independent reviewers extracted outcome data. Data were pooled using random-effects models and results between the intervention group and the expectative-policy group were compared using the χ2-test and t-test (α = 0.05, two-sided).

Results

Eight studies, five RCTs and three cohort studies with a control group, were included; there were 703 patients in the intervention group and 798 patients in the control group. Among the interventions, moxibustion was most commonly used treatment (five of the eight studies). In the RCTs, the proportion of breech presentations following treatment was 28% (95% CI 19–38%) vs. 67% (95% CI 53–80%) in the expectative-policy group. In the cohort studies plus controls these proportions were 15% (95% CI 1–28%) vs. 36% (95% CI 14–58%), respectively.

Conclusion

Our meta-analysis shows a positive effect of using acupuncture-type interventions on Bl 67 to induce correction of a breech position compared to expectative policy.

Acknowledgement

The Dutch Association for Acupuncture financially supported this study.

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