Pregnancy: Breech and Malposition Presentation
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For breech or other malposition presentation the ideal time to treat is before 33/34 weeks, after this the baby becomes increasingly too large to turn. However, even as late as 38 or 39 weeks some of these babies will turn. Research found that determination of the foetal position by ultrasound at 20 weeks does not predict foetal presentation at delivery. However, the examination at 30 weeks of gestation has substantial ability to predict nonvertex (head down) presentation at delivery (1). Furthermore, Professor Cheng Xinnong reports that in China clinical data shows that using acupuncture (usually 3 treatments) and moxibustion (warming acupuncture points) for a malpositioned foetus has a 90% success rate when applied between 28 to 32 weeks (2). Consequently, it is better to seek earlier treatment rather than wait.

After your consultation a treatment plan will be suggested. Usually three treatments over a period of 10 days will be recommended. During this time simple self-treatment is continued at home using a herb to warm acupuncture points. This treatment is not suitable for all pregnancies, contact Tracey Goulding prior to booking your session.

Acupuncture can be used in conjunction with external manual version. Midwives have commented that in their opinion there appears to be a higher success rate in those women who have been able to have acupuncture and self-treatment for at least five days before the procedure.

The New Zealand Evidence Based practice guidelines for care of women with Breech presentation (3) recommends that moxibustion may be offered to women from 33 weeks gestation. This follows research from Italy (4) that demonstrated moxibustion can have a significant effect in helping to turn breech babies. Later research has endorsed these earlier findings, concluding, "correction of a foetus in breech presentation in women at 33 weeks gestation, using Breech Version Acumoxa-Therapy on BL67, reduces the number of breech presentations at term, the number of caesarean sections and is less costly when compared to expectant management, including external cephalic version" (5). This research was based on the collation of cohort and Random Controlled Trials.

References:
(1) Natural History of Breech presentation: prognostic Value of ultrasound in the Generation r study. Van den Berg, I. et al.(2010-11). Published in a collection of studies: The Contribution of Acupuncture and Moxibustion to Healthcare, an Evidence-based Approach. PhD thesis by Erasmus University of Rottendam
(2) Xinnong, C. (2011) Acupuncture Therapeutics. Singing Dragon with People's Militrary Medical Press.
(3) http://www.nzgg.org.nz/guidelines/0074/caesarean
(4) Cardini F, Weixin H. (1998). “Moxibustion for correction of breech presentation”. Journal American Medical Association. 280:1580-1584.
(5) Ivan den Berg, I. et al (2008) Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: A systematic review. Complementary Therapies in Medicine, 2008 Apr;16(2):92-100.