A randomised controlled trial of moxibustion for breech presentation

Objectives To evaluate the efficacy of moxibustion for the correction of fetal breech presentation in a non-Chinese population.Design Single-blind randomised controlled trial (RCT).Setting Six obstetric departments in Italy.Sample Healthy non-Chinese nulliparous pregnant women at 32–33 weeks þ 3 days of gestational age withthe fetus in breech presentation.Methods Random assignment to treatment or observation. Treatment consisted of moxibustion (stimulationwithheatfromastickofArtemisiavulgaris)attheBL67acupuncturepoint(Zhiyin)foroneortwoweeks.Twoweeks after recruitment,eachparticipantwas subjected to anultrasonicexamination ofthe fetal presentation.Main outcome measure Number of participants with cephalic presentation in the 35th week.Results The study was interrupted when 123 participants had been recruited (46% of the planned sample).Intermediate data monitoring revealed a high number of treatment interruptions. At this point no differencewas found in cephalic presentation in the 35th week (treatment group: 22/65, 34%; control group: 21/58,36%; RR 0.95; 99% CI 0.59–1.5).Conclusions The results underline the methodological problems evaluating of a traditional treatment trans-ferred from a different cultural context. They do not support either the effectiveness or the ineffectiveness ofmoxibustion in correcting fetal breech presentation.INTRODUCTIONMoxibustion is a traditional Chinese therapy consistingof stimulation of acupuncture points with heat from theslow combustion of mixtures of medicinal grasses, mostoften Artemisia vulgaris (the Japanese name for which is‘moxa’). Little is known about the possible mechanism ofthis treatment.