Conversion Of Breech Presentation By Moxibustion Fumigation Of Zhiyin Point

The International Peace Maternity and Child Health Hospital, China Welfare Institute

This report consists of 2 parts: (1) 896 cases of breech pregnancies, gestation age of 28 weeks or above, were treated with moxibustion fumigation of "Zhiyin" point (bilateral), or by a combination with other measures, such as taking concoctions of Chinese herbal medicine, practising knee-chest position and external version. 855 cases were converted into vertex presentation, the total effective rate was 95.42%. Of these, 10.06% again reverted to breech presentation, but with further treatment, the presentation was again converted. There was no significant difference in the effective rates of primigravids and multigravids (P>0.05). But the rate was higher in pregnancies of gestation age between 28 and 30 weeks than in those over 31 weeks (P<0.05). 99.53% of the converted cases received a course of treatment consisting of moxibustion fumigation daily for three days. No adverse effects on the fetus and pregnant woman were noticed. There was no contraindication to moxibustion fumigation therapy. As compared to the other measures employed to affect version of breech presentation, moxibustion fumigation is a simple, safe and effective method which can be easily accepted by the pregnant woman.

Part (2) is a preliminary discussion of the possible mechanism of action of moxibustion fumigation of "Zhiyin" point. The fact that various forms of stimulation acting on "Zhiyin" point could result in nearly the same conversion rate, indicates that this specific point plays a major role. Moxibustion applied to "Baihui" or "Yong quan" point could also affect conversion of the breech presentation, but with moxibustion fumigation of "Shao shang" point, not a single case of breech was converted. It seemed that there existed a relative channel and point specificity.

At various periods before and after moxibustion fumigation of "Zhiyin" point, continuous records were made of the fetal movements, uterine contractions, fetal heart rate, and in some, photoelectric plethysmogram of the toe tip, in breech and stillborn pregnancies. After the same moxibustion fumigation treatment, none of the stillborn fetuses showed a version of its presenting part. On the other hand, with the living fetus, it was observed that the frequency and the amplitude of the active fetal movement increased and usually reached a peak level one hour after moxibustion fumigation or at night, and decreased on the following day. Those cases in which the breech was eventually converted, spontaneous version was noted sometime before or after the peak of fetal movement. Analysis of those cases in which spontaneous version failed to occur, showed that there were various factors which could interfere with spontaneous version, e. g. oligohydramnios, uterine deformities, impacted breech presenting parts, etc. In such conditions, it was still possible to raise the effective rate by instituting auxiliary measures, such as administration of concoction of herbal medicine, employment of knee-chest position or external version.