Clinical outcomes of breech presentations and changes of fetal movements after receiving acupuncture and moxibustion

Abstract

Purpose
The purpose of this study was to follow the treatment of acupuncture combined with moxibustion with the fetus in breech presentation and to explore the correlation between acupuncture, moxibustion and fetal movement.
Methods
Participants were pregnant women between 28-37 weeks gestational age, having a normal pregnancy until the diagnosis of fetal breech position, and wanting to receive acupuncture in combination with moxibustion. Mental and physical reactions, common pregnancy complaints, and fetal movements before and after the treatment were analyzed. The number of fetal movements was measured using Fetal Movement Acceleration Measurement (FMAM) as an objective index.
Results
A total of 12 women were eligible for inclusion (11 primiparas and one multipara) and the average age was 32.7 years. There were 24 treatments given to each participant. On each occasion all participants reported an increased warmth in their hands and feet. On 22 out of 24 treatments (91.7%), the participants stated they felt relaxed and sleepy post treatment. Participants felt no adverse effects post-treatment. Frequency of "cramping of feet" and "irritations" before treatments, significantly decreased post-treatment ("cramping of feet" z=-2.53, p=.011, "irritations" z=-2.00, p=.046; Wilcoxon signed-rank test). The cephalic version group comprised eight participants (66.7%); the breech presentation group whose fetus remained in the breech position even after treatment contained four participants (33.3%). The time from a breech presentation diagnosis to the start of treatment was as follows: the cephalic version group was an average of 8.6 days and the breech presentation group was an average of 27.3 days. Therefore, the cephalic version presentation group had a significantly shorter period than the breech presentation group (t =-3.7, p=.02) in seeking treatment. The cephalic version group was at an average of 31.5 weeks gestational age, whereas the breech presentation group was an average of 34.1 weeks gestational age for commencement of treatment. The cephalic version group began treatment substantially earlier, than the breech presentation group (t=-2.4, p=.04). The FMAM monitored fetal movements 20 minutes before treatment, again during the treatment and finally 20 minutes after the treatment. During treatment, the cephalic version group moved 173.71 times/hr, compared with the breech presentation group at 105.63 times/hr which was a significant difference (t=2.78, p=.02). Overall, fetal movements increased more "during treatment", or "20 minutes after treatment" in the cephalic version group.
Conclusion
Post-treatment, participants with the fetus in breech presentation felt a warmth of their hands and feet, were more relaxed and reported feeling sleepy. "Cramping of feet" and "irritations" felt by participants significantly decreased after treatment. A fetus position conversion rate was 66.7%. The cephalic version group started treatment an average of 8.6 days from diagnosis of breech presentation, and by an average of 31.5 weeks gestational age. In the cephalic version group, the fetal movement increased "during treatment" and "20 minutes after treatment". There were no adverse effects reported during these treatments.