title: Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews.
abstract: Threatened miscarriage is a common complication of early pregnancy increasing the risk of miscarriage or premature labour. Currently there is limited evidence to recommend any biomedical pharmacological or self-care management, resulting in a 'watchful waiting' approach. The objective of this study was to examine the feasibility of offering acupuncture as a therapeutic treatment for women presenting with threatened miscarriage.
  
  
  
  A mixed methods study involving a randomised controlled trial and semi structured interviews. A pragmatic acupuncture protocol including medical self-care advice was compared to an active control receiving touch intervention and medical self-care advice. Descriptive statistics were used to examine the demographic and baseline characteristics. Endpoints were analysed between groups using a mean t-test and chi-square tests with P < 0.05 considered statistically significant. Dichotomous data was expressed as Risk Ratio with 95 % confidence intervals. Eleven participants were purposively interviewed about their experiences on exiting the trial with interviews analysed using thematic analysis.
  
  
  
  Forty women were successfully randomised. For women receiving acupuncture there was a statically significant reduction with threatened miscarriage symptoms including bleeding, cramping and back pain compared with the control (p = 0.04). Thematic analysis revealed women were dissatisfied with the medical support and advice received. An overarching theme emerged from the data of 'finding something you can do.' This encompassed the themes: 'they said there was nothing they could do,' 'feeling the benefits' and 'managing while marking time.'
  
  
  
  Acupuncture was a feasible intervention and reduced threatened miscarriage symptoms when compared to a touch intervention. Further research is required to further explore acupuncture use for this common complication and whether it can reduce the incidence of miscarriage.
  
  
  
  Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12610000850077 . Date of registration 12/10/2010. Retrospectively registered, with first participant enrolled 11/10/2012.
authors.affiliation: National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. Debra.betts@nzsao.com.|New Zealand School Acupuncture and Traditional Chinese Medicine, P.O. Box 11076, Wellington, 6142, New Zealand. Debra.betts@nzsao.com.
authors.forename: Debra
authors.initials: D
authors.lastname: Betts
authors.affiliation: National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Smith
authors.affiliation: School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Dahlen
mesh_terms: D000022:Abortion, Spontaneous / Q000517:prevention & control* / Q000523:psychology; D000033:Abortion, Threatened / Q000523:psychology / Q000628:therapy*; D015670:Acupuncture Therapy / Q000379:methods* / Q000523:psychology; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011247:Pregnancy; D012107:Research Design; D016896:Treatment Outcome
keywords: Acupuncture; Feasibility study; Mixed methods; Randomised controlled trial; Supportive care; Threatened miscarriage