Thanks for posting this study on moxibustion, Marilyn.
Breech presentation is the primary reason for elective C.S. especially since
the (flawed) Hannah report which has convinced most ob's that it's the
safest way to go.
Moxibustion is a non-invasive intervention which is often talked about but
infrequently tried.  Recent figures indicate that 3-4% of babies are breech
at term (anecdotally it seems higher than that though, don't you think).
The chance of (natural) spontaneous version at 32 weeks is 57%, and at
36weeks only 25% will correct themselves without intervention.  This study
showed the group who had intervention (moxibustion/ECV) attained 75%
cephalic at term.  As midwives we could potentially reduce the ever-rising
C.S. rate simply by learning about and trying moxibustion whenever we are
presented with a woman who would like her breech baby to turn
"spontaneously".  Physical positioning exercises have been shown to be
effective, and can be combined with water (aqua robics style).   Acupuncture
is another alternative treatment worth exploring.  There is also a
chiropractic technique, but when I tried recently to find a chiro who would
do it I had no luck --  they knew how to do it, but "risk of litigation" was
cited as the reason they would not become involved.  I'm off to the chinese
herbalist shop this week to buy my moxa sticks!  Cheers, Lois

----- Original Message -----
From: <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>; <[EMAIL PROTECTED]>
Sent: Monday, April 08, 2002 11:15 PM
Subject: Re: 'turning' breech presentations.


The paper called "Moxibustion for Correction of Breech Presentation - a
Randomized Controlled Trial" by Cardini, F. and Weixin, H. was published in
JAMA 1998 Nov 11;280(18):1580-4. It was done in the outpatient dept. of the
Women's Hospital of Jiangi province, Nanchang, and Jiujiang Women's and
Children's Hospital in the People's Republic of China. The women were
primips
in their 33rd week with a u/s diagnosis of breech presentation. The 130
subjects randomized to the treatment group received stimulation of acupoint
BL67 by moxa (Artemisia vulgaris or mug wort) for 7 days with another 7 days
of treatment if fetus persisted in breech. The control subjects received
routine care but no interventions. Subjects with persistent breech after 2
weeks were offered ECV any time between 35 weeks and EDD. Main outcomes
increased fetal movement counts in treatment group vs controls; in 35 th
week
75.4% of fetuses in treatment group were cephalic vs 47.7% of fetuses in
control group. 24 subjects in the control group and 1 in the treatment group
underwent ECV. At birth 75.4 % of fetuses in the treatment group and 62.3%
of
fetuses in the control group were cephalic. 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.

I think timing is critical with this treatment. I have seen clients who
waited for the baby to turn by itself until 37 weeks and then the baby was
to
snug (it appeared to me) to turn, though ECV was often succesful at this
later gestation. marilyn
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