A  Acupuncture & Chinese Herbal Medicine Clinic
Moxibustion & Acupuncture for Breech Presentation

Moxibustion for correction of breech presentation: a randomized controlled trial.
Cardini F, Weixin H JAMA 1998 Nov 11;280(18):1580-4

CONTEXT: Traditional Chinese medicine uses moxibustion (burning herbs to stimulate acupuncture points)
of acupoint BL 67 (Zhiyin, located beside the outer corner of the fifth toenail), to promote version of fetuses
in breech presentation. Its effect may be through increasing fetal activity. However, no randomized controlled
trial has evaluated the efficacy of this therapy.

OBJECTIVE: To evaluate the efficacy and safety of moxibustion on acupoint BL 67 to increase fetal activity
and correct breech presentation.

DESIGN: Randomized, controlled, open clinical trial.

SETTING: Outpatient departments of the Women’s Hospital of Jiangxi Province, Nanchang, and Jiujiang
Women’s and Children’s Hospital in the People’s Republic of China.

PATIENTS: Primigravidas in the 33rd week of gestation with normal pregnancy and an ultrasound diagnosis
of breech presentation.

INTERVENTIONS: The 130 subjects randomized to the intervention group received stimulation of acupoint
BL 67 by moxa (Artemisia vulgaris) rolls for 7 days, with treatment for an additional 7 days if the fetus
persisted in the breech presentation. The 130 subjects randomized to the control group received routine
care but no interventions for breech presentation. Subjects with persistent breech presentation after 2 weeks
of treatment could undergo external cephalic version anytime between 35 weeks’ gestation and delivery.

MAIN OUTCOME MEASURES: Fetal movements counted by the mother during 1 hour each day for 1 week;
number of cephalic presentations during the 35th week and at delivery.

RESULTS: The intervention group experienced a mean of 48.45 fetal movements vs 35.35 in the control
group (Plessthan.001; 95% confidence interval [CI] for difference, 10.56-15.60). During the 35th week of
gestation, 98 (75.4%) of 130 fetuses in the intervention group were cephalic vs 62 (47.7%) of 130 fetuses in
the control group (Plessthan.001; relative risk [RR], 1.58; 95% CI, 1.29-1.94). Despite the fact that 24
subjects in the control group and 1 subject in the intervention group underwent external cephalic version, 98
(75.4%) of the 130 fetuses in the intervention group were cephalic at birth vs 81 (62.3%) of the 130 fetuses
in the control group ( P = .02; RR, 1.21; 95% CI, 1.02-1.43).

CONCLUSION: Among primigravidas with breech presentation during the 33rd week of gestation,
moxibustion for 1 to 2 weeks increased fetal activity during the treatment period and cephalic presentation
after the treatment period and at delivery.

Link to
The Original Article on JAMA (The Journal of the American Medical Association) November 11,
1998