How long to induce labor?

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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%">The evidence for acupuncture for induction of labour is contradictory. Whilst there are biologically plausible mechanisms for acupuncture’s effects there is no consistent evidence to support different treatment protocols or theoretical approaches. Acupuncture may increase uterine contractility either by central oxytocin release or by parasympathetic stimulation of the uterus (Tempfeer 1998). Electrical stimulation of sacral points and SP6 has been reported to be effective in cervical ripening and induction of labour (Tsuei 1974; Yip & Sung 1976). </div>
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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%">Needles used were sterile single use disposable 1 inch, 32 gage needles. Each treatment consisted of 6 needles applied to bilateral points LIV-3, SP6, and LI4. Needles were inserted to recommended depths and manipulated to achieve “deqi”. Needles were stimulated with strong manual stimulation at 10 minute intervals. Treatment duration was 30 minutes. Result: The patient was treated with the same treatment protocol for 3 days. Treatment was not effective for induction of labour. She was admitted for an induction of labour on the day after the third treatment. There were no adverse outcomes to treatment. She had a normal delivery and the baby was healthy. </div>
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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%">Needles used were sterile single use disposable 1 inch, 32 gage needles. Each treatment consisted of eight needles applied to bilateral points LIV-3, SP6, UB32, and UB33. The patient was treated in the lateral supine position. Needles were inserted into bilaterally into SP-6, LIV-3 to recommended depths and manipulated to achieve “deqi” BL-32 and BL-33 were needled to a depth of 1cm. LIV-3 was connected to UB 32; SP-6 was connected to UB-33 and stimulated with 30Hz electro acupuncture (intensity 3-6) adjusted to patients level of tolerance for 20 minutes on the first treatment. All the needles were removed after 20 minutes. </div>
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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%"> 3 hours after the first treatment she felt as if she began to have rhythmic “period like pains” and a show of blood and mucous. Treatment was repeated the next day (Saturday) at 3pm. By 5 pm she was having contractions 10 minutes apart, each contraction lasted approximately 30 seconds. She was admitted to hospital at 3.30am on Sunday. There were no apparent adverse outcomes after the first and second treatment. She was 10cm (fully) dilated by 7am (Sunday).</div>
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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%">In these cases electro acupuncture (30 Hz) and a segmental neuroanatomical approach incorporating TCM sacral points that have been shown to stimulate parasympathetic nerves innervating the uterus combined with distal TCM segmental points seemed to be more effective than manual stimulation of traditional acupuncture points reported to be effective for inducing labour. Safety has not been adequately investigated. Appropriately powered randomised trials are required to examine the effectiveness and safety of different theoretical acupuncture approaches for induction of labour and cervical ripening (Selmer-Olsen et al 2007; Smith et al 2008). </div>
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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%">Therese Parsons MSc Lic Ac</div>
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<div style="text-justify: kashida; margin: 0cm 2.85pt 0pt; line-height: 150%; text-align: justify; text-kashida: 0%">References </div>
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<div style="margin: 0cm 2.85pt 0pt; line-height: 150%">Selmer-Olsen T, Lydersen S, Mørkved S.Does acupuncture used in nulliparous women reduce time from prelabour rupture of membranes at term to active phase of labour? A randomised controlled trial. Acta Obstet Gynecol Scand. 2007; 86(12):1447-52.</div>
<div style="margin: 0cm 2.85pt 0pt; line-height: 150%">Smith CA, Crowther CA. Acupuncture for induction of labour. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD002962. DOI: 10.1002/14651858.CD002962.pub2</div>
<div style="margin: 0cm 2.85pt 0pt; line-height: 150%">Tempfeer C, Z. H., Heinzl H, Hefler L, Husslein P, Kainz CH,. (1998). Influence of </div>
<div style="margin: 0cm 2.85pt 0pt; line-height: 150%">acupuncture on maternal serum levels of interleukin-8, prostaglandin F2 alpha, and beta-endorphin: a matched pair study. Obstetrics & Gynecology, 92(2), 245-248.</div>
<div style="margin: 0cm 2.85pt 0pt; line-height: 150%">Tsuei JT, Lai Y. Induction of labour by acupuncture and electrical stimulation. Obstetrics & Gynecology 1974; 43(3):337–42.</div>
<div style="margin: 0cm 2.85pt 0pt; line-height: 150%">Tsuei JT, Lai Y, Sharma SD. The influence of acupuncture stimulation during pregnancy: the induction and inhibition of labour. Obstetrics& Gynecology 1977; 50:479–88.</div>
<div>Yip S, P. J., Sung M. (1976). Induction of labour by acupuncture electro stimulation. AmericanJournal of Chinese Medicine, 4(3), 257-265.Tempfeer C, Z. H., Heinzl H, Hefler L,</div>