Thanks Maralyn for putting this summary up to the list.  I have heard of 
moxibustion, but had not gone to the trouble of chasing up the literature.

Did anyone else think it's an interesting conclusion? If the treatment 
group and control group were about equal, the percentages given represent 
only a small difference in numbers for the outcome of cephalic presentation 
at birth - probably no statistical significance. Interesting that so many 
(24) in the control group had external version. Perhaps the ECV 
intervention may have made the difference.

There isn't enough evidence in this to make me advise clients who have 
babies presenting breech at 33 weeks to do anything.  At 35-36 weeks, I 
would discuss ECV and other possible measures like the moxa.

Also What does the finding of increased fetal activity signify?  Was there 
merely increased awareness of fetal activity?  Any comments?

>From a plain midwife who is very reluctant to interfere with the natural 
process.
Joy Johnston

-----Original Message-----
From:   [EMAIL PROTECTED] [SMTP:[EMAIL PROTECTED]]
Sent:   Tuesday, April 09, 2002 1:16 AM
To:     [EMAIL PROTECTED]; [EMAIL PROTECTED]
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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