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2015 ; 33
(5
): 413-9
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The safety of obstetric acupuncture: forbidden points revisited
#MMPMID26362792
Carr DJ
Acupunct Med
2015[Oct]; 33
(5
): 413-9
PMID26362792
show ga
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.