Acupuncture for induction of labour.
BACKGROUND
This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. The use of complementary therapies is rising and some women look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. The limited observational studies to date suggest acupuncture for induction of labour appears safe, has no known teratogenic effects, and may be effective. The evidence regarding the clinical effectiveness of this technique is limited.


OBJECTIVE
To determine the effects of acupuncture for third trimester cervical ripening or induction of labour.


METHODS
The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and bibliographies of relevant papers.


METHODS
The criteria for inclusion included the following: (1) clinical trials comparing acupuncture used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods; (2) random allocation to the treatment or control group; (3) adequate allocation concealment; (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusions.


METHODS
A strategy has been developed to deal with the large volume and complexity of trial data relating to labour induction. This involves a two-stage method of data extraction. The initial data extraction is done centrally, and incorporated into a series of primary reviews arranged by methods of induction of labour, following a standardised methodology. The data will then be extracted from the primary reviews into a series of secondary reviews, arranged by category of woman. To avoid duplication of data in the primary reviews, the labour induction methods have been listed in a specific order, from one to 25. Each primary review includes comparisons between one of the methods (from two to 25) with only those methods above it on the list.


RESULTS
No trials met the inclusion criteria for the systematic review.


CONCLUSIONS
There is a need for a well designed randomised controlled trial to evaluate the role of acupuncture to induce labour.
Smith
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Clinical Trials Unit, Department of Obstetrics and Gynaecolygy, Adelaide University, Women's and Children's Hospital, 72 King William Road, North Adelaide, Australia, SA 5006. caroline.anne.smith@adelaide.edu.au
Crowther
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D026881:Acupuncture; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third