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Acupuncture as an alternative technique in establishing uterine contractions in contraction stress test: A randomized controlled trial

Polla Lorenze K. Holgado, MD; Leah Socorro N. Rivera, MD, FPOGS, FPSMFM; Paula Christi P. Tolentino-Orlina, MD, DPOGS and Corazon R. Arcangel, MD
Department of Obstetrics and Gynecology, University of Santo Tomas Hospital

Background: Acupressure may stimulate oxytocin release from the pituitary gland, which in turn regulates uterine contractions to improve the progress of labor; hence, studies have shown that acupressure on the Spleen 6 (SP6) point may be a complementary strategy for augmenting labor and/or shortening the first stage of labor without causing adverse effects to the mother or the newborn.

Objective: To compare contractions produced by acupuncture technique from the contractions produced by conventional method using oxytocin in terms of: intensity, duration and interval of the uterine contractions and to determine if acupuncture technique at Sanyinjiao (spleen 6) and Hegu (Large Intestine 4) can be used as alternative method in establishing uterine contractions in Contraction Stress Test (CST) as a means of fetal surveillance.

Methodology: This is a Randomized Controlled Trial done in University of Santo Tomas Hospital. This included 54 term pregnant patients who met the inclusion criteria and were randomized into two groups: 27 patients in Acupuncture group and 27 patients in Oxytocin group (control group). All recruited patients were hooked to electronic fetal monitor to obtain baseline strips for 20 minutes. Acupuncture needles were applied bilaterally at Sanyinjiao (spleen 6) and Hegu (Large Intestine 4) for 20 minutes to the study subjects.

Results: Subjects who received acupuncture had greater intensity (p=0.551) and significant longer duration (p=0.001) of uterine contractions than the oxytocin group. However, there was significant shorter interval of uterine contractions after oxytocin treatment (p=0.013) than acupuncture. Furthermore, subjects who were in the acupuncture group obtained initial uterine contractions and achieved desirable uterine contractions faster than oxytocin.

Conclusion: Application of acupuncture in Spleen 6 (Sanyinjiao SP6) and Large Intestine 4 (Hegu LI4) can initiate and induce uterine contractions faster. Acupuncture technique when compared to the conventional method using oxytocin, produces stronger and longer contractions. Furthermore, there is shorter mean time to achieve initial and adequate contractions thru acupuncture technique. Contractions also disappear in a much shorter time in acupuncture technique than in oxytocin group hence ideal for outpatient setting.