The efficiency of acupuncture for nulliparas in actuating cervical ripening and spontaneous labour after 41 weeks (± 2 days) of normal pregnancy: Pilot study [M.S. Thesis]

Abstract

B A C K G R O U N D - Acupuncture is an ideal treatment alternative during pregnancy labour and birth as there are no severe side effects. Many studies report benefits of the use of acupuncture in actuating cervical ripening and spontaneous labour but its effectiveness needs to be assessed further. - O B J E C T I V E - This study serves as a pilot study for a future clinical trial that will evaluate the efficiency of acupuncture in actuating cervical ripening and spontaneous labour after 41 weeks (± 2 days) of normal pregnancy. - M E T H O D S - Healthy nulliparous women at 41 weeks (± 2 days) with a singleton normal pregnancy were randomized to either an acupuncture or control group. The control group received no treatment. The acupuncture group received one or two sessions of treatment: the first treatment at 41 weeks (±2 days) and the second at 41 weeks and 5 days (± 2 days), if they were not yet in spontaneous labour. Each acupuncture treatment consisted of four needles applied to the bilateral points Hegu (LI4) and Sanyinjiao (SP6). Cervical status was assessed using the modified Bishop score. The primary outcomes were: (1) the mean time from randomization to onset of the active phase of labour; (2) the incidences of medical inductions; and (3) ripening of the cervix from 41 weeks (± 2 days) to 41 weeks and 5 days (± 2 days). Secondary 10 outcomes included rates of Caesarean section, duration of labour and use of oxytocin during labour. As this was a pilot study, it was considered sufficient to have 16 participants in the study, eight in the acupuncture group and eight in the control group. - R E S U L T S - Sixteen women were randomized and completed the study procedure. No statistical difference in primary or secondary outcome was noted. - C O N C L U S I O N - As a pilot study, the sample size is small and no statistically significant results are presented. Data collection tools were reliable and no major practical difficulties were encountered. Some changes in the research plan for a future study are suggested. According to the study data, the intervention is probably of small effect size and therefore a large sample will be required to test the effectiveness of this intervention in a future clinical trial.