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Moxibustion for cephalic version: a feasibility randomised controlled trial.

Carole K Do¹, Caroline A Smith, Hannah Dahlen

¹School of Biomedical and Health Sciences, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 2751, Australia.

BMC Complementary and Alternative Medicine

|September 28, 2011

Summary

Moxibustion shows promise for correcting breech presentation, with acceptable compliance and positive feedback from women and clinicians, suggesting further research is warranted for this complementary therapy.

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Area of Science:

Obstetrics and Gynecology
Complementary and Alternative Medicine
Clinical Trial Feasibility

Background:

Moxibustion, a traditional Chinese medicine technique, is explored for its potential to correct breech presentation in pregnancy.
Existing systematic reviews show encouraging but heterogeneous evidence on moxibustion's effectiveness and safety.
This study assesses the feasibility of a randomized controlled trial (RCT) for moxibustion in an Australian context.

Purpose of the Study:

To evaluate the feasibility of conducting an RCT comparing moxibustion plus usual care versus usual care alone for promoting cephalic version in breech presentations.
To examine the perspectives of women and healthcare providers on implementing such a trial.
To gather preliminary data on clinical outcomes and feasibility metrics for a larger future study.

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Main Methods:

A randomized controlled trial was conducted at a public hospital in Australia.
Women (34-36.5 weeks gestation) with singleton breech presentation were randomized to moxibustion plus usual care or usual care.
Feasibility outcomes included recruitment rate, acceptability, compliance, and sample size estimation. Clinical outcomes and qualitative interviews with clinicians were also assessed.

Main Results:

Twenty women were randomized, with a 51% acceptance rate among those approached.
A trend towards increased cephalic version at delivery (RR 5.0) and greater success with external cephalic version (ECV) was observed with moxibustion.
Compliance was acceptable, with no reported side effects. Clinicians expressed support for moxibustion to increase birth choices.

Conclusions:

The study was underpowered, necessitating cautious interpretation of the observed trends.
High acceptance rates among women and positive clinician feedback support the need for further research into moxibustion's safety and efficacy.
An estimated sample size of 381 women is required for a future definitive trial.