Treatments of pelvic girdle pain in pregnant women: adverse effects of standard treatment, acupuncture and stabilising exercises on the pregnancy, mother, delivery and the fetus/neonate.
BACKGROUND
Previous publications indicate that acupuncture is efficient for the treatment of pelvic girdle pain, PGP, in pregnant women. However, the use of acupuncture for PGP is rare due to insufficient documentation of adverse effects of this treatment in this specific condition. The aim of the present work was to assess adverse effects of acupuncture on the pregnancy, mother, delivery and the fetus/neonate in comparison with women that received stabilising exercises as adjunct to standard treatment or standard treatment alone.


METHODS
In all, 386 women with PGP entered this controlled, single-blind trial. They were randomly assigned to standard treatment plus acupuncture (n = 125), standard treatment plus specific stabilising exercises (n = 131) or to standard treatment alone (n = 130) for 6 weeks. Acupuncture that may be considered strong was used and treatment was started as early as in the second trimester of pregnancy. Adverse effects were recorded during treatment and throughout the pregnancy. Influence on the fetus was measured with cardiotocography (CTG) before-during and after 43 acupuncture sessions in 43 women. A standardised computerized method to analyze the CTG reading numerically (Oxford 8000, Oxford, England) was used. After treatment, the women rated their overall experience of the treatment and listed adverse events if any in a questionnaire. Data of analgesia and oxytocin augmentation during labour, duration of labour, frequency of preterm birth, operative delivery, Apgar score, cord-blood gas/acid base balance and birth weight were also recorded.


RESULTS
There were no serious adverse events after any of the treatments. Minor adverse events were common in the acupuncture group but women rated acupuncture favourably even despite this. The computerized or visually assessed CTG analyses of antenatal recordings in connection with acupuncture were all normal.


CONCLUSIONS
This study shows that acupuncture administered with a stimulation that may be considered strong led to minor adverse complaints from the mothers but had no observable severe adverse influences on the pregnancy, mother, delivery or the fetus/neonate.
Elden
Helen
H
Perinatal Center, Department of Obstetrics and Gynecology, Institute for Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/East, Gothenburg University, Gothenburg, SE-416 85, Sweden. helen.elden@vgregion.se
Ostgaard
Hans-Christian
HC
Fagevik-Olsen
Monika
M
Ladfors
Lars
L
Hagberg
Henrik
H
D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D001416:Back Pain / Q000628:therapy; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010147:Pain Measurement / Q000379:methods; D017699:Pelvic Pain / Q000628:therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome