Guest guest Posted June 19, 2006 Report Share Posted June 19, 2006 I am reviewing a European text, by Ansgar Roemer, MD called Medical Acupuncture in Pregnancy. In it he claims " The traditional review and the prohibition of use of certain points during pregnancy is obsolete and not corroborated by our understanding of pathophysiology....There are no contraindicated points during pregnancy! There are only contraindicated manipulation techniques...The old lists of acupucnture points...and the apparently non-sensical differentiaion of points according to the month of pregnancy can only be historically justified. " He clarifies his statement that stimulating techniques such as strong manual stimulation and regional electrostim which affect the uterus, are contraindicated. He mentions the use of LI 4 (Hegu) prenatally for infections, addictions, pain and headache & migraine. Sp 6 (San yin jiao) is mentioned in the treatment of Pregnancy induced hypertension and pre-eclampsia (known as EPH-Gestosis in Europe). I have used a protocol for some morning sckness cases due to liver depression, depressive heat overacting on the stomach which includes LI4, without much stimulation on the point. I have never had an inkling of ill effect, quite the opposite. When I leave the point out, the treatment is not so effective. In trying to create contractions, it always takes significant stimulation using " prohibited points " with repeated treatments. I have just never seen such a casual reference to using these points for so many conditions during pregnancy. I have other issues with the book itself, but I am left wondering what we really know about LI4 & SP6 in pregnency. For how many conditions would we use them in treatment? What do others think? Valerie Hobbs Dipl. OM _______________ Don’t just search. Find. Check out the new MSN Search! http://search.msn.click-url.com/go/onm00200636ave/direct/01/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2006 Report Share Posted June 19, 2006 Hi Valerie, I do not have the reference but I was told about a study where woman tried to deal with unwanted pregancies by using all the " forbidden points " . None of them had a miscarriage. Artemis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 19, 2006 Report Share Posted June 19, 2006 I have never had a problem with the prohibited points during pregnancy. Deep needling in the abdomen during the last trimester of course is contraindicated for obvious reasons, but the distal points don't seem to do anything negative to mother or baby. The schools put in a lot of fear about using these points during pregnancy and it seems most people are afraid of trying them from that point forward. Very strong stimulation (low frequency electro-stim at the threshold of pain) of UB32, 33 or 34 can cause a baring down sensation which can start labor. LI-4, SP-6, GB-20 & UB-60 have never done anything as far as inducing a miscarriage or starting labor when desired in my experience. However, I do believe that UB-67 (with moxa) can turn a malpostioned baby. I would be very interested in hearing about any research (besides classical reference) that shows LI-4 or Sp-6 do anything contraindicated for pregnancy. Sp-6 can be used to treat restless fetus, so clearly it can't be that contraindicated. :-) Christopher Vedeler L.Ac., C.Ht. Oasis Acupuncture http://www.oasisacupuncture.com 8233 N. Via Paseo del Norte Suite D-35 Scottsdale, AZ 85258 Phone: (480) 991-3650 Chinese Medicine Chinese Medicine On Behalf Of VALERIE HOBBS Monday, June 19, 2006 1:13 PM Chinese Medicine LI4/SP 6 in pregnancy I am reviewing a European text, by Ansgar Roemer, MD called Medical Acupuncture in Pregnancy. In it he claims " The traditional review and the prohibition of use of certain points during pregnancy is obsolete and not corroborated by our understanding of pathophysiology....There are no contraindicated points during pregnancy! There are only contraindicated manipulation techniques...The old lists of acupucnture points...and the apparently non-sensical differentiaion of points according to the month of pregnancy can only be historically justified. " He clarifies his statement that stimulating techniques such as strong manual stimulation and regional electrostim which affect the uterus, are contraindicated. He mentions the use of LI 4 (Hegu) prenatally for infections, addictions, pain and headache & migraine. Sp 6 (San yin jiao) is mentioned in the treatment of Pregnancy induced hypertension and pre-eclampsia (known as EPH-Gestosis in Europe). I have used a protocol for some morning sckness cases due to liver depression, depressive heat overacting on the stomach which includes LI4, without much stimulation on the point. I have never had an inkling of ill effect, quite the opposite. When I leave the point out, the treatment is not so effective. In trying to create contractions, it always takes significant stimulation using " prohibited points " with repeated treatments. I have just never seen such a casual reference to using these points for so many conditions during pregnancy. I have other issues with the book itself, but I am left wondering what we really know about LI4 & SP6 in pregnency. For how many conditions would we use them in treatment? What do others think? Valerie Hobbs Dipl. OM _______________ Don't just search. Find. Check out the new MSN Search! http://search.msn.click-url.com/go/onm00200636ave/direct/01/ Subscribe to the new FREE online journal for TCM at Times http://www.chinesemedicinetimes.com Download the all new TCM Forum Toolbar, click, http://toolbar.thebizplace.com/LandingPage.aspx/CT145145 and adjust accordingly. Messages are the property of the author. Any duplication outside the group requires prior permission from the author. Please consider the environment and only print this message if absolutely necessary. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2006 Report Share Posted June 20, 2006 Just as an aside. If you have AAC as you malpractice proviner then read the fine print under Part V. Exclusions to coverage for which there will be " NO Defense or Payment of Damages " is listed " Obstetrics and Gynecology, including the delivery of babies, or care of newborn infants until they are fourteen (14) days old. " I.e., if a pregnant woman looses her baby (for what ever reason) you are not covered. Kelvin Chinese Medicine , " Christopher Vedeler L.Ac. " <ckvedeler wrote: > > I have never had a problem with the prohibited points during pregnancy. > Deep needling in the abdomen during the last trimester of course is > contraindicated for obvious reasons, but the distal points don't seem to > do anything negative to mother or baby. The schools put in a lot of > fear about using these points during pregnancy and it seems most people > are afraid of trying them from that point forward. Very strong > stimulation (low frequency electro-stim at the threshold of pain) of > UB32, 33 or 34 can cause a baring down sensation which can start labor. > LI-4, SP-6, GB-20 & UB-60 have never done anything as far as inducing a > miscarriage or starting labor when desired in my experience. However, I > do believe that UB-67 (with moxa) can turn a malpostioned baby. > > I would be very interested in hearing about any research (besides > classical reference) that shows LI-4 or Sp-6 do anything contraindicated > for pregnancy. Sp-6 can be used to treat restless fetus, so clearly it > can't be that contraindicated. :-) > > Christopher Vedeler L.Ac., C.Ht. > Oasis Acupuncture > http://www.oasisacupuncture.com > 8233 N. Via Paseo del Norte > Suite D-35 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2006 Report Share Posted June 20, 2006 On of my teachers told me about a study in China (I dont have any references to it) where the aim of treatment was to cause termination of pregnancy with acupuncture. They apparantly didnt have any success. Im sure if someone is able to dig around in the Chinese literature long enough they are bound to turn up a study of this nature (perhaps not recent or particularly good methodology), as I believe this must have been investigated as an abortion option in China, at least given my experiences of interning in the gynae dept. there. If it worked, they'd be using it. I feel that in a healthy pregnancy with a vigorous mother, there is little risk from acupuncture (but yes, strong stimulation should be avoided), however, especially in the first trimester, there are so many pregnancies that end up being miscarried naturally that just to be on the safe side, its better to be very carefull. That way, both you and the patient KNOW that it wasnt your treatment that caused it. Add to this the fact that in the west there are so many older mothers having their first child (the average age of first time mothers in Australia is 32 years old), often after fertility treatment of some kind, and having an increased incidence of things like gestational diabetes and pre-eclampsia and eclampsia due in part to an older maternal age, and well....be careful. In my own experience, I had LI4 needled on me in the first trimester with very strong stimulation several times, and I wasnt concerned. I also used acupuncture to try and induce labour with limited success. I tend to feel that babies are going to do what they are going to do, and theres not much that can be done about it (unless you start with the syntocinon or something.) I was in labour for several days with a posterior baby and so tried everything to get labour to advance. LI 4, Sp6, Bl32 and then some, also using electro-stim. It worked a treat while the needles were in, but then would stop as soon as they were removed. (I didnt try and turn the baby as I didnt realize he had turned posterior until later.) But then, I also did alot of heavy lifting and a whole bunch of other things you really shouldnt in both my pregnancies, with no ill effect, but I would not recommend it to anybody. I personally would not needle into the sacral foramena in pregancy unless induction of labour was the aim, and deep needling into the abdomen (depending on the fundal height) is a no brainer, but the distal points dont overly concern me. Regards, Lea. --- In Chinese Medicine , " acupuncturebeverlyhill s " <acupuncturebeverlyhills wrote: > > Just as an aside. > If you have AAC as you malpractice proviner then read the fine print > under Part V. Exclusions to coverage for which there will be " NO > Defense or Payment of Damages " is listed " Obstetrics and Gynecology, > including the delivery of babies, or care of newborn infants until > they are fourteen (14) days old. " > I.e., if a pregnant woman looses her baby (for what ever reason) you > are not covered. > > Kelvin > > > > > Chinese Medicine , " Christopher > Vedeler L.Ac. " <ckvedeler@> wrote: > > > > I have never had a problem with the prohibited points during > pregnancy. > > Deep needling in the abdomen during the last trimester of course is > > contraindicated for obvious reasons, but the distal points don't > seem to > > do anything negative to mother or baby. The schools put in a lot > of > > fear about using these points during pregnancy and it seems most > people > > are afraid of trying them from that point forward. Very strong > > stimulation (low frequency electro-stim at the threshold of pain) > of > > UB32, 33 or 34 can cause a baring down sensation which can start > labor. > > LI-4, SP-6, GB-20 & UB-60 have never done anything as far as > inducing a > > miscarriage or starting labor when desired in my experience. > However, I > > do believe that UB-67 (with moxa) can turn a malpostioned baby. > > > > I would be very interested in hearing about any research (besides > > classical reference) that shows LI-4 or Sp-6 do anything > contraindicated > > for pregnancy. Sp-6 can be used to treat restless fetus, so > clearly it > > can't be that contraindicated. :-) > > > > Christopher Vedeler L.Ac., C.Ht. > > Oasis Acupuncture > > http://www.oasisacupuncture.com > > 8233 N. Via Paseo del Norte > > Suite D-35 > > Scottsdale, AZ 85258 > > Phone: (480) 991-3650 > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2006 Report Share Posted June 20, 2006 Dear Kelvin, The general exclusion of gynaecology in your policy seems a bit harsh. How general do you make this to be? Lea. --- In Chinese Medicine , " acupuncturebeverlyhills " <acupuncturebeverlyhills wrote: Exclusions to coverage for which there will be " NO > Defense or Payment of Damages " is listed " Obstetrics and Gynecology, > including the delivery of babies, or care of newborn infants until > they are fourteen (14) days old. " > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 21, 2006 Report Share Posted June 21, 2006 I'll check my my insurance tomorrow. Treating pregnant women for any reason (morning sickness, aches and pains of pregnancy etc.) could potentially leave one uninsured. If it is only " delivery of babies " then does labor induction fall into that since one isn't actually delivering? Christopher Vedeler L.Ac., C.Ht. Oasis Acupuncture http://www.oasisacupuncture.com 8233 N. Via Paseo del Norte Suite D-35 Scottsdale, AZ 85258 Phone: (480) 991-3650 Fax: (480) 247-4472 Chinese Medicine Chinese Medicine On Behalf Of acupuncturebeverlyhills Monday, June 19, 2006 5:07 PM Chinese Medicine Re: LI4/SP 6 in pregnancy Just as an aside. If you have AAC as you malpractice proviner then read the fine print under Part V. Exclusions to coverage for which there will be " NO Defense or Payment of Damages " is listed " Obstetrics and Gynecology, including the delivery of babies, or care of newborn infants until they are fourteen (14) days old. " I.e., if a pregnant woman looses her baby (for what ever reason) you are not covered. Kelvin Traditional_ <Chinese Medicine%40> Chinese_Medicine , " Christopher Vedeler L.Ac. " <ckvedeler wrote: > > I have never had a problem with the prohibited points during pregnancy. > Deep needling in the abdomen during the last trimester of course is > contraindicated for obvious reasons, but the distal points don't seem to > do anything negative to mother or baby. The schools put in a lot of > fear about using these points during pregnancy and it seems most people > are afraid of trying them from that point forward. Very strong > stimulation (low frequency electro-stim at the threshold of pain) of > UB32, 33 or 34 can cause a baring down sensation which can start labor. > LI-4, SP-6, GB-20 & UB-60 have never done anything as far as inducing a > miscarriage or starting labor when desired in my experience. However, I > do believe that UB-67 (with moxa) can turn a malpostioned baby. > > I would be very interested in hearing about any research (besides > classical reference) that shows LI-4 or Sp-6 do anything contraindicated > for pregnancy. Sp-6 can be used to treat restless fetus, so clearly it > can't be that contraindicated. :-) > > Christopher Vedeler L.Ac., C.Ht. > Oasis Acupuncture > http://www.oasisacu <http://www.oasisacupuncture.com> puncture.com > 8233 N. Via Paseo del Norte > Suite D-35 > Scottsdale, AZ 85258 > Phone: (480) 991-3650 > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 21, 2006 Report Share Posted June 21, 2006 At 09:44 PM 6/20/2006, Christopher Vedeler wrote: >I'll check my my insurance tomorrow. > >Treating pregnant women for any reason (morning sickness, aches and >pains of pregnancy etc.) could potentially leave one uninsured. If it >is only " delivery of babies " then does labor induction fall into that >since one isn't actually delivering? > My mal-practice policy (Medical Insurance Exchange of California) explicitly excludes: 1) using disposable needles 2) direct moxa, and 3) peri-natal treatment Properly treating pregnant women (following contraindication guidelines, common sense, and astute diagnosis) for morning sickness, etc,. i.e. general imbalances would seem to involve no more liability than practice in general. My office-mate/colleage -- an MD and L.Ac (with genuine CM education) -- does Atx regularly to help induce labor, at or over term. As an MD he's clearly on different footing. One could argue that simply treating to " move blood " in the absence of actual labor is in order. I have done that. But, in the spirit of the insurance dictum, treatment in/around labor would be out of the scope of the coverage. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 21, 2006 Report Share Posted June 21, 2006 On the Prohibition of Acupuncture of Hegu(LI4)and Sanyinjiao(SP6)during Pregnancy JIN Chun-lan, ZHU Jiang(College of Acu-moxibustion,Beijing University of Traditional Chinese Medicine,Beijing,100029) ABSTRACT: Because there are different viewpoints about prohibition of AP at Hegu (LI4) and Sanyinjiao (SP6) during pregnancy, in the present paper, the authors make a preliminary analysis on the theoretical basis and time-window and reasonable application of contraindicant acupoints from 1) descriptions about acupuncture contraindication in Chinese ancient and modern medical books; 2) knowledge about the activities of the uterus during pregnancyin modern obstetrics and gynecology; 3) clinical and experimental researches on the effect of acupuncture on the functional activities of the uterus; 4) effects of acupuncture on the uterine contraction in different stages of pregnancy, and 5) possible mechanisms of the effect of acupuncture in different stages. In addition, the authors hold that 1) contraindicant acupoint do exist, acupuncture of LI4 and SP6 may facilitate the contraction of the uterus in all the pregnant stages, so there will be a possibility of miscarriage, 2) the sensitivity of the pregnant uterus to acupuncture stimulation may be increases along with the development of pregnancy, so acupuncture therapy should be used cautiously in the early and middle stages prohibited in the advanced stage and for gravida with weak constitution or habitual abortion. In the discourse, the writers also bring forward an initial idea that for stopping pregnancy, pregnancy-contraindicant acupoints may be applicable after changes of the functional state of pregnancy by applying drugs, and increasing the stimulation strength within the patients' tolerance is probably favorable to raising clinical therapeutic effect. I found 34 articles dealing with the subject of acupuncture and abortion (liu chan). However, most of these articles deal with the combination of acupuncture and earAP with western medicines (mainly mifepristone). Most of these articles show that both body acupuncture (LI4 and SP6 being the most widely used points) and ear acupuncture increase efficiency of induced abortion, reduce pain and side-effects, etc). Acupuncture may also be used to prevent post-abortion complications. I haven't had time to read the article quoted above, but both classical and modern sources seem to find that AP can influence pregnancy. I wouldn't be so quick to dismiss the cautionary words... Tom. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2006 Report Share Posted June 22, 2006 Not sure if this has already been mentioned but in the study 'Influence of AP on the pregnancy rate in patients who undergo assisted reproduction therapy', Fertility and Sterility, April 2002, the protocol for AP 25 minutes after the embryo has been transferred includes the points Hegu (LI4) and Sanyinjiao (SP6), the idea being to affect the autonomic nervous system to make the lining of the uterus more receptive to the receiving of the embryo. Angelo Chinese Medicine , " Tom Verhaeghe " <tom.verhaeghe wrote: > > On the Prohibition of Acupuncture of Hegu(LI4)and Sanyinjiao(SP6) during > Pregnancy > JIN Chun-lan, ZHU Jiang(College of Acu-moxibustion,Beijing University of > Traditional Chinese > Medicine,Beijing,100029) > ABSTRACT: Because there are different viewpoints about prohibition of AP at > Hegu (LI4) and Sanyinjiao (SP6) during pregnancy, in the present paper, the > authors make a preliminary analysis on the theoretical basis and time-window > and reasonable application of contraindicant acupoints from 1) descriptions > about acupuncture contraindication in Chinese ancient and modern medical > books; 2) knowledge about the activities of the uterus during pregnancyin > modern obstetrics and gynecology; 3) clinical and experimental researches on > the effect of acupuncture on the functional activities of the uterus; 4) > effects of acupuncture on the uterine contraction in different stages of > pregnancy, and 5) possible mechanisms of the effect of acupuncture in > different stages. In addition, the authors hold that 1) contraindicant > acupoint do exist, acupuncture of LI4 and SP6 may facilitate the contraction > of the uterus in all the pregnant stages, so there will be a possibility of > miscarriage, 2) the sensitivity of the pregnant uterus to acupuncture > stimulation may be increases along with the development of pregnancy, so > acupuncture therapy should be used cautiously in the early and middle stages > prohibited in the advanced stage and for gravida with weak constitution or > habitual abortion. In the discourse, the writers also bring forward an > initial idea that for stopping pregnancy, pregnancy-contraindicant acupoints > may be applicable after changes of the functional state of pregnancy by > applying drugs, and increasing the stimulation strength within the patients' > tolerance is probably favorable to raising clinical therapeutic effect. > > I found 34 articles dealing with the subject of acupuncture and abortion > (liu chan). However, most of these articles deal with the combination of > acupuncture and earAP with western medicines (mainly mifepristone). Most of > these articles show that both body acupuncture (LI4 and SP6 being the most > widely used points) and ear acupuncture increase efficiency of induced > abortion, reduce pain and side-effects, etc). Acupuncture may also be used > to prevent post-abortion complications. > I haven't had time to read the article quoted above, but both classical and > modern sources seem to find that AP can influence pregnancy. I wouldn't be > so quick to dismiss the cautionary words... > Tom. > > Quote Link to comment Share on other sites More sharing options...
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