Acupuncture as an abortifacient per se - a myth?

June 21, 2006

Hi All,

Can any of you cite studies, preferably with abstracts, that prove (or suggest

strongly) that AP can induce abortion on its own? If not, the opinion by some

listers that one can use AP safely in pregnancy (i.e. with no or minimal risk

of inducing miscarriage / abortion), may be well founded.

A search of Pubmed Medline gives several abstracts that show that AP has

significant effects in induction of birth near full term, inhibition of

threatened

miscarriage, analgesia for obstetric operations, including cervical dilation for

D & C and abortion by suction, and assisting the expulsion of uterine

contents in abortion induced by drugs/herbs..

HOWEVER, there is little evidence in Medline that AP can induce abortion

on its own. See abstracts, below.

Best regards,

Liang S, Guo Q, Bi XX, Zhang Y, Li TJ, Lin ZC. [Clinical pathological

observation on acupuncture increasing medicine-induced complete abortion

rate] [Article in Chinese] Zhongguo Zhen Jiu. 2005 Oct;25(10):696-8.

Obstetrical and Gynecological Department, Shijiazhuang Fourth Hospital,

Hebei 050011, China. skykenbao OBJECTIVE: To probe into

the method for effectively increasing complete abortion rate of medicine-

induced abortion and observe pathological changes. METHODS: Two

hundred cases were randomly divided into an observation group and a

control group, 100 cases in each group. The observation group were treated

by acupuncture at Hegu (LI 4), Sanyinjiao (SP 6), Neiguan (PC 6) and

Kunlun (BL 60), and the control group were not treated by acupuncture. The

abortion rate, bleeding condition, adverse reaction and pathological

changes were observed in the two groups. RESULTS: The complete

abortion rate was 96.0% in the observation group, better than 88.0% in the

control group (P < 0.05). There were significant differences between the two

groups in bleeding time and pathological changes (P < 0.05).

CONCLUSION: Acupuncture can increase complete abortion rate of

medicine-induced abortion, with shorter bleeding time and less residual

villus. PMID: 16318127 [PubMed - in process]

Ding M, Xue WH, Zhang Y, Yan JY, Wang YJ. [Observation on clinical

therapeutic effect of acupuncture combined with medicine on abortion]

[Article in Chinese] Zhongguo Zhen Jiu. 2005 Oct;25(10):693-5. Hebei TCM

Hospital, Shijiazhuang 050011, China. minding2005

OBJECTIVE: To observe clinical therapeutic effect of acupuncture

combined with medicine on abortion. METHODS: Two hundred and twenty-

six cases of early pregnancy who asked medicine-induced abortion were

divided into a treatment group and control groups A and B. In the treatment

group, after taking the final once medicine acupuncture treatment was

given, and in the control group A, after taking the final once medicine oral

administration of ShengHua Tang, and the control group B were treated by

nothing. RESULTS: The complete abortion rate, colporrhagia lasting time,

amount of bleeding in the treatment group were superior to those in the

control groups (P < 0.05). The amount of bleeding in the control group A

was superior to that in the control group B (P < 0.05). CONCLUSION:

Acupuncture can increase the complete abortion rate, shorten colporrhagia

lasting time, reduce bleeding amount and increase sensitivity of the

organism to medicine. PMID: 16318126 [PubMed - in process]

Ying YK, Lin JT, Robins J. Acupuncture for the induction of cervical

dilatation in preparation for first-trimester abortion and its influence on HCG.

J Reprod Med. 1985 Jul;30(7):530-4. Cervical dilatation in preparation for

first-trimester abortion using acupuncture at loci SP6 and LI4 was studied in

20 patients, who were compared to a control group in whom no preparation

was used. Ninety percent of the patients had successful acupuncture

procedures. As judged by Hegar dilators, the increase in cervical dilatation

in those 18 patients was significantly greater than in the controls. No

significant side effects were observed. The effect of acupuncture on serum

human chorionic gonadotropin (HCG) as a pregnancy marker was

evaluated in 12 patients. No statistically significant difference in the change

in HCG was noted in terms of the controls, indicating an absence of

abortifacient activity with acupuncture. PMID: 4032390 [PubMed - indexed

for MEDLINE]

Xiao B, Wang M. Birth control techniques in China. China Popul Newsl.

1983 Dec;1(2):1-7. This article describes the major birth control techniques

in use in China, based on data from a contraceptive prevalence study

conducted in September, 1982. 118 million of the 170 million married

women of child bearing age use birth control. IUD insertion accounts for

50.2% of birth control methods used, tubal ligation accounts for 25.4%, vas

deferens ligation 10.0% oral contraceptives (OCs) 8.2%, and condoms

2.0%. A table of clinical data on 9 China made IUDs reveals that pregnancy

rates range from 0 (V Cu-300 model) to 5.83% (mixed ring model). A

method of IUD insertion immediately after delivery has been researched

and adopted, using a silastic Delta IUD with barium added to reduce the

high postpartum expulsion rate. fixing the IUD by sutures during Cesarean

section has also been developed. Electronmicroscopic studies of the

endometrium of women who have used a stainless steel IUD for more than

20 years showes no tendency towards malignancy, nor negative effects on

the endocrine functions of the ovaries. 28 million Chinese women have

accepted sterilization as of June, 1982. Local anesthesia and the use of

acupuncture have reduced complications due to general anesthesia seen

previously. Sterilization by means of chemically induced adhesion of

Fallopian tube tissue has also been performed successfully; however, this

method makes later anastomosis difficult, and is not suitable for young

women with only 1 child. Fallopian tube occlusion by means of a silver clip

has been performed in 1,128 cases, with a pregnancy rate of only .85%.

10.62 million men have accepted sterilization. While most of the procedures

are val ligations, 300,000 men have been sterilized by direct injection of an

adhesive agent throuh the skin of the scrotum. No increase in auto immune

or vascular disease has been found. 3 low-dose OCs, used since 1969,

have proven to be reliable and freer of side effects than higher-dose

compounds. In addition, longterm OCs containing quinestrol have been

used since 1969 with a success rate of 98.3% women-year. These pills are

taken 1x monthly. R and D priority will be given be given to monthly

injectable contraceptives; megestrol and norethindrone are the compounds

most preferable. In trials so far, the effective rate has been 99.9% with mild

side effects. Gossypol, a male contraceptive, has shown an antifertility

effect in 99% of 8000 cases studied; however, hypokalemia and

irreversibility of spermatogenesis were reported in some cases. Vacuum

suction is the most common method for abortion, but Radix Trichosanthis

and lilac daphne terpine, traditional abortifacients, anre acceptable for 1st

trimester abortions. Prostaglandins are also used. PMID: 12312957

[PubMed - indexed for MEDLINE]

Serfaty D, Buttigieg C, Dreyfus R. [induced abortion under acupunctural

analgesia (25 cases)] [Article in French] Contracept Fertil Sex (Paris). 1979

Aug;7(8):557-62. The article reports on the first 25 cases of induced

abortion practiced under acupunctural analgesia in France. 5 points were

touched on the body, and 3 on the ear. The 25 patients, all between 19-40,

did not feel any pain, except in one single case. Bleeding was minimal,

duration of intervention about 10-15 minutes, and duration of hospitalization

very short, about 2h.30'. The major advantages of analgesia through

acupuncture are its total safety, and, especially, the fact that it leaves the

patient totally conscious, establishing a better relationship between patient

and doctor. PMID: 12278210 [PubMed - indexed for MEDLINE]

Macaigne M, Playoust D, Sabbe G, Zylberberg G. [Analgesic abortion

through acupuncture] [Article in English, French] Contracept Fertil Sex

(Paris). 1979 Apr;7(4):265-70. Electroacupuncture was used to obtain

analgesia in 100 cases, including abortion via curettage, cesarean section

and regular delivery. Psychological factors such as anxiety and depression

are not conducive to acupuncture. Patients undergoing the procedure

should be informed about the intervention. Premedication is often advisable,

although not always necessary. Analgesia is obtained about 20 minutes

after starting stimulation of the points utilized; most of these are, for this

procedure, located in the legs and arms. Results from the study of these

cases were totally positive. PMID: 12309447 [PubMed - indexed for

MEDLINE]

[No authors listed] [A symptom-complex during artificial abortion (author's

transl)] [Article in Chinese] Zhonghua Fu Chan Ke Za Zhi. 1979

Apr;14(2):111-5. Some women undergo induced abortion manifest a series

of symptoms such as slower heart beats, irregular heart rate, lowered blood

pressure, paleness, dizziness and profuse perspiration. These symptoms,

which occur during or after the procedure, are referred to as " a symptom

complex. " In 1977, 400 pregnant women were studied to determine the

cause of this symptom complex: 263 healthy women who received normal

treatment; 32 women with heart ailments associated with early pregnancy,

who received acupuncture; and 105 women whose heart rates were below

90, who were injected with 0.5 mg atropine. Virtually all of the 263 women

had a slower heart rate during the procedure. 33 (12.55%) of these women

exhibited the symptom complex, and of these, 23 (69.17%) had cramps, 17

(51.52%) had abdominal swelling, and 2 (6.09%) had backaches. Most of

these symptoms occurred when the cervix dilated and after the suction. The

duration and seriousness of the symptom complex varied from woman to

woman, as did the recovery period, which ranged from 3 to 63 minutes. It

was also found that: 1) of the 263 patients, 110 were first time mothers, of

whom 15 (13.63%) had the symptom complex; 2) of the 221 healthy women

who had abortion by suction, 32 (14.48%) had the symptom complex, while

1 (2.38%) who had abortion by pincers, had the symptom complex; 3) of the

33 women who had the symptom complex, the loss of blood ranged from 10

ml to 200 ml, with an average loss of 50 ml; 4) there appears to be no

relationship between the manifestation of the symptom complex and

negative pressure; 5) electrocardigrams were taken for 20 of the healthy

patients, none of whom showed a quickened heart rate during or after the

procedure; and 6) treatment for the symptom complex was by acupuncture

or by injection of Atropine. The 32 acupuncture patients suffered only

backaches and lower abdominal swelling, but relief of pain was slow. 105

patients were administered Atropine, none of whom manifested the

symptom complex. Only 19 women perspired slightly and felt chilled in the

limbs, while 3 were nauseous. Of the 33 symptom complex patients, 5 had

Atropine, most of whose heart rates returned to normal after 2 seconds to 2

minutes, as did their dizziness, perspiration, and ashen coloring. However, it

was found that if no treatment was given after the symptom complex

emerged, a majority of the patients returned to normal on their own, some

taking as long as an hour. It is believed the occurrence of the symptom

complex is directly related to the mechanical stimulus applied to the uterus

or cervix, the vigorous shrinkage of the uterus, loss of blood, and the

negative pressure suction power of the uterine wall. Further a mechanical

stimulus to the uterus can cause an " errant " nervous reflex that will affect

the heart rate. This errant nervous reflex can be cut off by an injection of

Atropine. PMID: 263029 [PubMed - indexed for MEDLINE]

Janaud A. [i.V.G. with or without anesthesia] [Article in English, French]

Contracept Fertil Sex (Paris). 1977 Dec;5(9):719-28. The need for general

anesthesia in conjunction with vacuum aspiration abortions is discussed.

General anesthesia is used in 75-85% of such operations performed in

France. Iv anesthesia is used for general anesthesia in conjunction with

vacuum aspiration abortions. General anesthesia is effective, safe, and

rapid. Operations performed in conjunction with general anesthesia are

generally better organized, with more trained medical personnel in

attendance. The patient usually has more contact with medical personnel

before the operation and for the approximate 12-hour hospitalization period

after the operation. Conversely, bleeding is more abundant after general

anesthesia and some patients have bad experiences (e.g., hallucinations)

while being revived. The period of hospitalization and recuperation can be

inconvenient. The paracervical block and cervical anesthesia are the types

of local anesthesia used in performing vacuum aspiration abortions;

tranquilizers are administered prior to the operation. Acupuncture and

hypnotism have been used in a limited number of cases. The same surgical

and postoperative safety measures should be followed for patients who

have general or local anesthesia. Vacuum aspiration abortions should not

be preformed under local anesthesia after the 9th week of pregnancy.

Multiparae may undergo vacuum aspiration without local anesthesia if the

dilation is not painful. Vacuum aspiration abortion may have undesirable

psychological side effects. The routine for performing vacuum aspiration

abortions may not be well organized. It would take about 15 minutes to

perform the operation without general anesthesia. 25-33% of the women

who want to undergo vacuum aspiration abortion should have general

anesthesia. The advantages of local anesthesia are the fact that it offers an

alternative, it is ambulatory, it reduces the cost of the operation, and more of

the patients return for checkups. PMID: 12308837 [PubMed - indexed for

MEDLINE]

Tsuei JJ, Lai Y, Sharma SD. The influence of acupuncture stimulation

during pregnancy: the induction and inhibition of labor. Obstet Gynecol.

1977 Oct;50(4):479-8. Uterine response to electroacupuncture stimulation

of specific sites of the extremities is demonstrated in 60 pregnant women--

48 cases for labor induction and 12 cases for inhibition of premature labor.

In the 34 term, post-term, and 7 intrauterine fetal death cases, induction of

labor was attempted; in 32 cases delivery was achieved, resulting in a

success rate of 78%. In 7 cases of midterm abortion attempts, all failed to

respond. Of the 12 cases of premature labor, with the exception of 1 case,

all carried the pregnancy to term, resulting in a success rate of 91.6%.

Based on these clinical observations, electroacupuncture may become a

useful tool in controlling labor. The possible mechanism of action is

discussed. Further investigation and standardization of this technique is

proposed. PMID: 904813 [PubMed - indexed for MEDLINE]

Best regards,

HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

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<

" Man who says it can't be done should not interrupt man doing it " - Chinese

Proverb

June 21, 2006

, " "

< wrote:

>

> Ying YK, Lin JT, Robins J. Acupuncture for the induction of

cervical

> dilatation in preparation for first-trimester abortion and its

influence on HCG.

> As judged by Hegar dilators, the increase in cervical dilatation

> in those 18 patients was significantly greater than in the

controls.

Phil,

Thanks for looking up the studies, very interesting.

OK, so if you had a patient who had an incompetent cervix (what a

term....), if this study is representational (the n. is small, but

its not an easy study to organize), then one would think that

acupuncture should then be used with a certain amount of caution. So

to be on the safe side, if you dont necessarily know whether a

primipara patient has an incompetent cervix, what should you then

do?

Regards,

Lea.

June 21, 2006

I will search wanfangdata when I get my new login. I should get it in a few

days.

Tom.