-IBIS-1.7.6-
tx
reproductive system
breech position
Acupuncture

patterns and combinations

after assessing the person and palpating, consider these patterns:
Constitutional Kidney Xu (Deficiency) leads to injury of Kidney leading to Xu (Deficiency) of Jing and Xue (Blood); Loss of equilibrium between Kidney Channel of Foot Xiao Yin and Urinary Bladder Channel of Foot Tai Yang

» therapeutic note:
• primary effectiveness before the 34th week of pregnancy

» research findings: Studies in China have reported malposition of the fetus corrected in 90.3% during the 29th through the 40th week of pregnancy, with 86% of these responding after one to four treatments, and the remaining 14% after five to ten treatments (Flaws, 1983, p. 43)
A randomized, controlled open clinical trial involving 130 subjects, primigravidas in the 33rd week of gestation, found treatment at UB-67 (zhi yin) was associated with increased fetal movements and increased occurrence of cephalic presentation at delivery. (Cardini F, Weixin H. JAMA 1998 Nov 11;280(18):1580-1584.)


point analysis

» therapeutic note:
• if you are unsure about contraindications, check the list of "forbidden and caution points" in the materia medica regarding appropriateness during pregnancy

» palpate and consider:
UB-67 (D): regulates pregnancy; causes uterine contractions; indirect moxa 15 minutes daily until fetal position corrected; Bladder Jing Well, Metal and Tonification point

• if treatment of UB-67 is not effective, consider moxa at GV-20, Kd-1 and/or Lu-11 (Flaws, 1983, p. 43):

• GV-20 (D): regulates and tonifies the Qi (D); adjusts Qi of the Du Mai (Governing Vessel); stimulates the pineal; calms the fetus (D); Jiao Hui Intersecting point of the six Yang channels and the Du Mai (Governing Vessel)
• Kd-1 (D): reinforces the Kidney; nourishes Yin and benefits Jing (Essence); moves the Qi and adjusts the fetus; Kidney Jing Well, Wood, Dispersion and Entry point
• Lu-11 (D): restores Yang; frees channel Qi; Lung Jing Well and Wood point

• CV-8 (D on salt): raises placenta and fetus that has slipped or dropped prematurely (Flaws, 1983, p. 45)


footnotes

Cardini F, Weixin H. Moxibustion for correction of breech presentation: a randomized controlled trial. JAMA 1998 Nov 11;280(18):1580-1584.
Abstract: CONTEXT: Traditional Chinese medicine uses moxibustion (burning herbs to stimulate acupuncture points) of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of fetuses in breech presentation. Its effect may be through increasing fetal activity. However, no randomized controlled trial has evaluated the efficacy of this therapy. OBJECTIVE: To evaluate the efficacy and safety of moxibustion on acupoint BL 67 to increase fetal activity and correct breech presentation. DESIGN: Randomized, controlled, open clinical trial. SETTING: Outpatient departments of the Women's Hospital of Jiangxi Province, Nanchang, and Jiujiang Women's and Children's Hospital in the People's Republic of China. PATIENTS: Primigravidas in the 33rd week of gestation with normal pregnancy and an ultrasound diagnosis of breech presentation. INTERVENTIONS: The 130 subjects randomized to the intervention group received stimulation of acupoint BL 67 by moxa (Japanese term for Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus persisted in the breech presentation. The 130 subjects randomized to the control group received routine care but no interventions for breech presentation. Subjects with persistent breech presentation after 2 weeks of treatment could undergo external cephalic version anytime between 35 weeks' gestation and delivery. MAIN OUTCOME MEASURES: Fetal movements counted by the mother during 1 hour each day for 1 week; number of cephalic presentations during the 35th week and at delivery. RESULTS: The intervention group experienced a mean of 48.45 fetal movements vs 35.35 in the control group (P<.001; 95% confidence interval [CI] for difference, 10.56-15.60). During the 35th week of gestation, 98 (75.4%) of 130 fetuses in the intervention group were cephalic vs 62 (47.7%) of 130 fetuses in the control group (P<.001; relative risk [RR], 1.58; 95% CI, 1.29-1.94). Despite the fact that 24 subjects in the control group and 1 subject in the intervention group underwent external cephalic version, 98 (75.4%) of the 130 fetuses in the intervention group were cephalic at birth vs 81 (62.3%) of the 130 fetuses in the control group (P = .02; RR, 1.21; 95% CI, 1.02-1.43). CONCLUSION: Among primigravidas with breech presentation during the 33rd week of gestation, moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation after the treatment period and at delivery.