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A Journal on Internal Medicine and Pharmacology

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2003 August;162(4):105-109

language: Italian

Acu­punc­ture to ­induce ­labour and pro­vide ­pain ­relief: a pos­sible pro­to­col

Palermo P. 1, Di Stanislao C. 2, Patacchiola F. 1, Di Stefano L. 1, Coppola G. 1, Mascaretti G. 1

1 Clinica Ostetrica e Ginecologica, Università degli Studi di L’Aquila, Ospedale Civile S. Salvatore, L’Aquila;
2 Divisione Ospedaliera di Dermatologia, Ospedale Civile S. Salvatore, L’Aquila

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The ­study con­sid­ers the use of acu­punc­ture to ­induce ­labour and pro­vide ­pain ­relief, and indi­cates a pos­sible pro­to­col. Acu­punc­ture ­offers ­many ther­a­peu­tic pos­sibil­ities in the gynaec­o­log­i­cal and obstet­ric ­fields. The prin­ci­pal use is ­based on ­acupuncture’s abil­ity to con­trol ­pain. One of the ­most-stud­ied ­aspects con­cerns ­pain ­relief dur­ing ­labour. At ­today’s ­state of knowl­edge, the accept­ed ­effects of acu­punc­ture dur­ing ­labour may be ­summed up in ­4 ­points: ­action on ­pain and anx­ie­ty; ­action on the dura­tion and ­nature of ­labour; ­action on the myo­me­tri­al con­trac­til­ity and on the ­neck of the uter­us; con­se­quent pos­i­tive ­effect on ­well-­being of moth­er and foe­tus. The ­pain ­relief pro­duced by acu­punc­ture is ­achieved by rais­ing the ­pain thresh­old, ­with ­improved ute­rine per­fu­sion and mod­i­fied con­trac­tile activ­ity. The treat­ment caus­es ­less fre­quent and some­times irreg­u­lar con­trac­tions, ­which are there­fore ­less pain­ful. ­Since ­each wom­an is dif­fer­ent and there­fore ­each preg­nan­cy and ­each deliv­ery is dif­fer­ent, ­even dif­fer­ing ­from the ­same ­woman’s pre­vi­ous expe­ri­enc­es, it is prac­ti­cal­ly impos­sible to estab­lish a beha­vi­our pro­to­col ­that is repeat­able in eve­ry obstet­ric sit­u­a­tion. ­Despite ­this, ­after hav­ing eval­u­at­ed the poten­tial ­risk, guide­lines ­must be ­drawn up ­that deter­mine clin­i­cal con­duct ­with ­regard to the use of acu­punc­ture to ­induce ­labour, and ­that ­ensure a ­good ­degree of over­all suc­cess. A pre­lim­i­nary and abso­lute selec­tion ­excludes all wom­en ­with a med­i­cal his­to­ry con­cern­ing the pre­vi­ous preg­nan­cy ­that is pos­i­tive for CT or for the use of for­ceps. It is ­also abso­lute­ly essen­tial to ­make a pre­cise eval­u­a­tion, on the ­basis of clin­i­cal and/or instru­men­tal ­data, tak­ing ­into ­account any fac­tors ­that ­increase the ­risk to moth­er and/or foe­tus-neo­nate, ­which ­must ­direct the cli­ni­cian ­towards dif­fer­ent and con­sol­i­dat­ed choic­es.

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