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The safety of obstetric acupuncture: forbidden points revisited

BACKGROUND/AIM: Although the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be ‘forbidden’ during pregnancy. This article reviews the scientific literature on this topic. MAIN FINDINGS: There is no o...

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Autor principal: Carr, David John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680134/
https://www.ncbi.nlm.nih.gov/pubmed/26362792
http://dx.doi.org/10.1136/acupmed-2015-010936
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author Carr, David John
author_facet Carr, David John
author_sort Carr, David John
collection PubMed
description BACKGROUND/AIM: Although the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be ‘forbidden’ during pregnancy. This article reviews the scientific literature on this topic. MAIN FINDINGS: There is no objective evidence of harm following needling at forbidden points, summarised by the following four lines of evidence. (1) In 15 clinical trials (n=823 women receiving n=4549–7234 acupuncture treatments at one or more forbidden points) rates of preterm birth (PTB) and stillbirth following are equivalent to those in untreated control groups and consistent with background rates of these complications in the general population. (2) Observational studies, including a large cohort of 5885 pregnant women needled at forbidden points at all stage of pregnancy, demonstrate that rates of miscarriage, PTB, preterm prelabour rupture of membranes (PPROM), and preterm contractions (preterm labour (PTL) or threatened PTL) are comparable with untreated controls and/or consistent with their anticipated incidence. (3) There is no reliable evidence that acupuncture/electroacupuncture (EA) can induce miscarriage/labour, even under otherwise favourable circumstances such as post-dates pregnancy or intrauterine fetal death. (4) Laboratory experiments using pregnant rats have demonstrated that repeated EA at forbidden points throughout gestation does not influence rates of post-implantation embryonic demise or cause miscarriage, fetal loss or resorption. CONCLUSIONS: These findings are reassuring and will help individualised risk:benefit assessment before treating pregnant women. Given the numerous evidence-based indications for obstetric acupuncture and lack of evidence of harm, risk:benefit assessments will often fall in favour of treatment.
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spelling pubmed-46801342015-12-18 The safety of obstetric acupuncture: forbidden points revisited Carr, David John Acupunct Med Education and Practice BACKGROUND/AIM: Although the safety of acupuncture per se in pregnancy is reasonably well accepted, there remains debate regarding needling at points historically considered to be ‘forbidden’ during pregnancy. This article reviews the scientific literature on this topic. MAIN FINDINGS: There is no objective evidence of harm following needling at forbidden points, summarised by the following four lines of evidence. (1) In 15 clinical trials (n=823 women receiving n=4549–7234 acupuncture treatments at one or more forbidden points) rates of preterm birth (PTB) and stillbirth following are equivalent to those in untreated control groups and consistent with background rates of these complications in the general population. (2) Observational studies, including a large cohort of 5885 pregnant women needled at forbidden points at all stage of pregnancy, demonstrate that rates of miscarriage, PTB, preterm prelabour rupture of membranes (PPROM), and preterm contractions (preterm labour (PTL) or threatened PTL) are comparable with untreated controls and/or consistent with their anticipated incidence. (3) There is no reliable evidence that acupuncture/electroacupuncture (EA) can induce miscarriage/labour, even under otherwise favourable circumstances such as post-dates pregnancy or intrauterine fetal death. (4) Laboratory experiments using pregnant rats have demonstrated that repeated EA at forbidden points throughout gestation does not influence rates of post-implantation embryonic demise or cause miscarriage, fetal loss or resorption. CONCLUSIONS: These findings are reassuring and will help individualised risk:benefit assessment before treating pregnant women. Given the numerous evidence-based indications for obstetric acupuncture and lack of evidence of harm, risk:benefit assessments will often fall in favour of treatment. BMJ Publishing Group 2015-10 2015-09-11 /pmc/articles/PMC4680134/ /pubmed/26362792 http://dx.doi.org/10.1136/acupmed-2015-010936 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Education and Practice
Carr, David John
The safety of obstetric acupuncture: forbidden points revisited
title The safety of obstetric acupuncture: forbidden points revisited
title_full The safety of obstetric acupuncture: forbidden points revisited
title_fullStr The safety of obstetric acupuncture: forbidden points revisited
title_full_unstemmed The safety of obstetric acupuncture: forbidden points revisited
title_short The safety of obstetric acupuncture: forbidden points revisited
title_sort safety of obstetric acupuncture: forbidden points revisited
topic Education and Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680134/
https://www.ncbi.nlm.nih.gov/pubmed/26362792
http://dx.doi.org/10.1136/acupmed-2015-010936
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