Scientific Articles

Clinical experience in acupuncture goes back thousands of years. The conclusions of recent research demonstrate that following acupuncture treatments endorphins were secreted and pain-carrying nervous fibers were inhibited. In addition, even though its mechanisms of action are still unclear, the NIH and the WHO recognize acupuncture's efficacy in the treatment of many disorders.

Many studies are specific to obstetrical-acupuncture and demonstrate that it is simple, cheap and safe. Acupuncture is a tool used by many obstetrical practitioners around the world and it starts to be integrated here in Quebec.


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Acupuncture in Obstetrics Recent Research Literary Review Resume
by Virginie Dostie-Toupin

- Acupuncture is practiced since thousands of years and is recognized as effective in the treatment of many disorders (such as pain and aches, migraines, nausea) by the WHO and the NIH. (1,2,3)

- Acupuncture analgesic action does not have to be proven anymore. A lot of research has been made on this topic showing good results in treating migraines and pain of any kind.

- Acupuncture mechanisms can be explained by its action on the nervous system mediation of pain, by the micro inflammation that it creates locally increasing the blood flow and reducing the inflammation, by the beta-endorphins secretion it triggers and by interacting with the connective tissue as Dr. Langevin discovered in her study. (4, 5, 6)

Acupuncture in obstetrics

Studies about acupuncture's indications before pregnancy indicate that acupuncture:

- increases beta-endorphins secretion which influence gonadotropics hormones secretion and thus menstrual cycle(7)

- as an inhibitor effect on SNS that increases uterine blood flow (7)

- affects cerebral genes expression which normalises the secretion of a few hormones like; GnRH, LH and E2 (8)

- stimulate ovulation (9,10)

- increases the quality of the sperm (11)

- has great successes in infertility cases characterized by amenorrhea with progesterone tests positives (12)

- increases by 16% the chances of an IVF to work (13)

For pregnancy monitoring acupuncture is really effective to:

- treat nausea and throw up (14,15,16) this because beta-endorphins and ACTH secretion increases and this leads to inhibition of CTZ and emetic centre of the brain which leads to decrease acid secretion and gastric arrhythmias (17)

- treat lower back pain(18,19)

- treat general symptoms a pregnant woman can get without being aloud to take medication to treat it, such as: allergies, headaches, insomnia, urinary tract infections, etc.(20)

- facilitate correction of breech position (85% effective) (21,22) and increasing amniotic fluid index

- prepare the perinea and increase Bishop score in preparation for labor(23,24)

- encourage the uterine cervix ripening and reduce time interval between planned and actual delivery date(25)

During labor, acupuncture can play an important role in:

- accelerating the first phase of labor (24,25)

- decreasing stress and anxiety (26,27,28)

- decreasing pain sensation and need for analgesics (18,25)

In post-partum, indications of treatment which efficacy have been proven by research are:

- post-partum depression (26,27,28)

- mastitis (29,30)

- hypogalactia (31,32)

Acupuncture is a tool integrated in obstetrics in many countries :

- In France, nurses, midwives and obstetricians use it frequently since 1950.

- In USA, acupuncture is used in a lot of fertility centers.

- In Denmark, after testing the use of acupuncture at the Frederik Hospital a recommendation is made to integrate this practice. (33)

- In Russia, the treatments done resulted in positive conclusions both for women and children. (34)

- In Nigeria, acupuncture is a great tool since it is efficient and cheap.(35)

Bibliography

(1)Organisation mondiale de la santé. Use of acupuncture in modern health care, WHO Chron 1980 Jul-Aug;34(7-8):294-301

(2)Acupuncture. National Institutes of Health Consensus Development Conference Statement. États-Unis, November 3-5, 1997. [Consulté le 1er octobre 2002]. http://odp.od.nih.gov

(3)National Institutes of Health. Acupuncture. NIH Consens Statement 1997 Nov 3-5;15(5):1-34. Synthèse d'études. Eskinazi DP, Jobst KA. National Institutes of Health Office of Alternative Medicine-Food and Drug Administration Workshop on Acupuncture, J Altern Complement Med 1996 Spring;2(1):3-6 (4)Ma SX. Neurobiology of Acupuncture: Toward CAM.Evid Based Complement Alternat Med. 2004 Jun 1;1(1):41-47.Departments of Obstetrics and Gynecology, Harbor-UCLA Medical Center, David Geffen School of Medicine at University of California at Los Angeles, Torrance, CA, USA. (5)Ahn AC, Wu J, Badger GJ, Hammerschlag R, Langevin HM. Electrical impedance along connective tissue planes associated with acupuncture meridians. Fletcher Allen Health Care, University of Vermont General Clinical Research Center, VT, USA. aahn@hms.harvard.edu (6)Han JS. Acupuncture and endorphins. BMC Complement Altern Med. 2005 May 9;5(1):10.

(7)Chang R, Chung PH, Rosenwaks Z. Role of acupuncture in the treatment of female infertility. Fertility and Sterility 78 (6): 1149-1153, Dec 2002.

(8)Chen By. Acupuncture normalises dysfonction of HPOA. AP Electrother Res 22 (2):97-108. Institute of AP, Shanghai Medical University.

(9)Cerovsky J,Hudecek V, Rozkot M, Harapat D, Hercick Z. AP to induce Oestrus in Gilts. Web journal of acupuncture, Http://users.med.auth.gr. Prevysov, Czech Republic.

(10) Chen BY (1984) A preliminary study on catgut embedding at point SP06 to induce ovulation. Chin J Integ Tradit West Med 4 (9):521-522, 514.

(11)Fischl F; Riegler R; Biegelmayer Ch (1984) AP therapy of subfertility Dtsch Z Akupunkt 27 (3): 53-56. Also Fischl F; Riegler R, Bieglmayer C, Nasr F, Neumark J (1984) Modification of semen quality by AP in subfertile men. Geburtshilfe Frauenheikd Aug; 44 (8) : 510-512

(12)Gerhard I, Postneek F (1988) Possibilities of therapy by AP in female sterility. Geburtshilfe Frauenheilkd Mars;48 (3) :165-171.

(13) W.E. Paulus, M. Zhang, E. Strehler, I. El-Danasouri and K. Sterzik , Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fert Steril 77 (2002), pp. 721-724.

(14)Aloysio D, Penacchioni P. Morning sickness control in early pregnancy. Department of Obstetrics and Gynecology, Bologna University, Italy. Obstet Gynecol 1992 Nov;80(5):852-854

(15)Hyde E. Acupressure therapy for morning sickness. Acontrolled clinical trial. J Nurse Midwifery 1989 Jul;34(4):171-178

(16)Dundee JW, Sourial FB, Ghaly RG, Bell PF. P6 acupressure reduces morning sickness. Department of Anaesthetics, Queen's University, Belfast. JR Soc Med 1988 Aug; 81(8):456-457.

(17) Samuels N. Acupuncture for nausea: how does it work? Harefuah 142 (4): 297-300, 316, Apr 2003.

(18) Kvorning Nina. Acupuncture in obstetrics and anesthesia. Department of anaesthesia and intensive care, Hospital of Helsingborg, Sweden, Lund university dissertation abstracts, 2003-07-029

(19) Tsuei JJ (1987) AP treatment in modern practice of Obs and Gyn. WFAS first conf (UK): 98-99.

(20) Becke H (1982) Neural therapy and acupuncture in obstetric and gynecology. Zentralbl Gynakol 104 (10): 602-609.

(21)Cardini F; Basevi V; Valentini A; Martellato A (1991)Moxibustion and breech presentation: pleliminary results. ACJM 19 (2) :105-114. Division of obst. And gynecol., Zevio Hospital, Verona, Italy.

(22) Neri I, Airola G, Contu G, Allais G, Facchinetti F, Benedetto C. Acupuncture plus moxibustion to resolve breech presentation: a randomized controlled study. Department of Obstetrics and Gynecology, University of Modena-Reggio Emilia, Modena, Italy. J Matern Fetal Neonatal Med. 2004 Apr;15(4):247-52.

(23) Tremeau ML, Fontaine-Ravier P, Demouzon J. Acupuncture for cervical maturation. Journal

de gynécologie, obstétrique et biologie de la reproduction, 1992, 21(4) :375-80

(24) RABL and collegues. Acupuncture for cervical ripening and induction of labor at term - a randomized controlled trial. Department of Obstetrics and Gynecology, université de Vienne, Autriche. Wiener Klinische Wochenschrift 113 (23-24):942-6. Dec. 2001.

(25) Dr. Joanne Douglas. Acupuncture: does it work? Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario. BJOG 2002;109: 637-44

(26) A. Chen , An introduction to sequential electric acupuncture (SEA) in the treatment of stress related physical and mental disorders. Acupunct Electrother Res 17 (1992), pp. 273-283. (27) J.T. Dong , Research on the reduction of anxiety and depression with acupuncture. Am J Acupunct 21 (1993), pp. 327-330.

(28) H. Luo, F. Meng, Y. Jia and X. Zhao , Clinical research on the therapeutic effect of the electroacupuncture treatment in patients with depression. Psychiatry Neurosci 52 (Clin 1998), pp. S338-340.

(29) Gao DK; Su JM; Liu CA(1986) Efficacy of AP at GB21 in 394 cases of acute mastitis. JTCM 6(1): 19-20.

(30) Liang ZP (1988) 32 cases of acute mastitis treated with AP, moxibustion and cupping. JTCM 8(1):15-18.

(31)Fava A, Bongiovanni A, Frassoldati P (1980) Acupuncture therapy of hypogalactia. Minerva Med Dec 22; 71 (51): 3747-52.

(32)Huang YS (1992) Postpartum oligogalactia treated by AP: Report of 56 cases. New Journal of TCM 24 (1):32-33.

(33) Spellerberg E, Smidt-Jensen. A retrospective analysis of the results of obstetric acupuncture at Frederiksberg Hospital. SL.DK-2000 Frederiksberg. PubMedindex: 12645408

(34)Dr. Tamara Khwan, Dr. Irina Kim. Acupuncture in obstetrics. Women Hospital, Sacchalin, Russia. Abstracts of ICMART'97 International Medical Acupuncture Symposium

(35)Umeh BU (1986) Sacral AP for pain relief in partution: initial clinical experience in Nigerian women. AP research 11 (2):147-151.