Meta-analysis of the effect of acupressure on duration of labor and mode of delivery

摘要

Background: Acupressure is increasing in popularity as an alternative treatment in obstetrics and gynecology. Objectives: To summarize and assess evidence regarding the effects of acupressure on duration of labor and mode of delivery. Search strategy: Four major databases and Google Scholar were searched using terms related to labor and acupressure, without language restrictions, up to November 2015. Selection criteria: Randomized controlled trials were included if they examined the effect of acupressure at any acupoint during childbirth on duration of labor and/or mode of delivery. Data collection and analysis: Two reviewers independently extracted data. The outcome measures were duration of labor and mode of delivery. Random-effects models were used to pool results. Main results: Thirteen studies were included in meta-analyses. Acupressure increased the chance of vaginal delivery when compared with placeboo intervention (odds ratio [OR] 2.329,95% confidence interval [CI] 1.348-4.024, P=0.002; risk difference [RD] 8.9%, 95% CI 2.7%-15.0%, P=0.005). Acupressure decreased the duration of the active phase by 1.310 hours (95% CI-1.738 to -0.882; P<0.001) and the second stage of labor by 5.808 minutes (95% CI-1.615 to -0.807; P<0.001). Conclusions: Acupressure could have a role in reducing the rate of cesarean delivery and decreasing the duration of labor in parturient women. However, there is a need for more reliable randomized controlled trials. (C) 2016 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.