Impact of anesthetic agents on the amount of bleeding during dilatation and evacuation: A systematic review and meta-analysis

Purpose Patients undergo dilatation and evacuation for abortion or miscarriage. However, bleeding is sometimes problematic. Despite reports on the association between volatile anesthetics and increased bleeding during the procedure, firm evidence is lacking. Therefore, we conducted a systematic review and meta-analysis to compare the effects of volatile anesthetics and propofol on the amount of bleeding in patients undergoing dilatation and evacuation. Methods We conducted a systematic search of four databases, namely PubMed, Embase, Cochrane Central Register of Controlled Trials databases, and Web of Science (Clarivate Analytics), from their respective inception to April 2021. Moreover, we searched two trial registration sites. The inclusion criterion was randomized controlled trials of patients who underwent dilatation and evacuation under general anesthesia using volatile anesthetics or propofol. The primary outcome was the amount of perioperative bleeding. The mean difference of the bleeding was combined using a random-effects model. The I2 statistic was used to assess heterogeneity. We assessed risk of bias with Cochrane domains. We controlled type I and II errors due to sparse data and repetitive testing with Trial Sequential Analysis. We assessed the quality of evidence with GRADE. Results Five studies were included in the systematic review. The amount of bleeding was compared in four studies and was higher in the volatile anesthetic group, with a mean difference of 164.7 ml (95% confidence interval, 43.6 to 285.7; p = 0.04). Heterogeneity was considerable, with an I2 value of 97%. Two studies evaluated the incidence of significant bleeding, which was significantly higher in the volatile anesthetic group (RR, 2.42; 95% confidence interval, 1.04–5.63; p = 0.04). Conclusion Choosing propofol over volatile anesthetics during dilatation and evacuation might reduce bleeding and the incidence of excessive bleeding. However, the quality of the evidence was very low. This necessitates further trials with a low risk of bias. Trial registration PROSPERO (CRD42019120873).

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Relationship between hormonal contraceptives and sleep among women of reproductive age: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-045819 ◽

2021 ◽

Vol 11 (10) ◽

pp. e045819

Author(s):

Jinhui Ma ◽

Megan Cheng ◽

Lehana Thabane ◽

Caihong Ma ◽

Ning Zhang ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Research Question ◽

Risk Of Bias ◽

Reproductive Age ◽

Hormonal Contraceptives ◽

Controlled Trials ◽

Cochrane Central Register ◽

Women Of Reproductive Age

IntroductionThe aetiology of sleep disruptions is unknown, but hormonal fluctuations during the menstrual cycle, pregnancy and menopause have been shown to potentially affect how well a woman sleeps. The aim of this systematic review was to investigate whether hormonal contraceptives are associated with a decreased quality of sleep and increased sleep duration in women of reproductive age.MethodsThis review will analyse data from randomised controlled trials or non-randomised comparative studies investigating the association between hormonal contraceptives and sleep outcomes among women of reproductive age. Reviews addressing the same research question with similar eligibility criteria will be included. A literature search will be performed using the MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases from inception to 7 March 2021. The Cochrane Collaboration’s Risk of Bias for Randomised Trials V.2.0 and The Risk of Bias for Non-randomised Studies of Interventions tool will be used to assess risk of bias for each outcome in eligible studies. Two reviewers will independently assess eligibility of studies and risk of bias and extract the data. All extracted data will be presented in tables and narrative form. For sleep measures investigated by two or more studies with low heterogeneity, we will conduct random-effects meta-analysis to estimate the magnitude of the overall effect of hormonal contraceptives. If studies included in this systematic review form a connected network, a network meta-analysis will be conducted to estimate the comparative effect of different contraceptives. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to summarise the quality of evidence. Our protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 guidelines.Ethics and disseminationEthics approval is not required as data were sourced from previously reported studies. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences.PROSPERO registration numberCRD42020199958.

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Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: A systematic review and meta-analysis

10.21203/rs.2.18558/v2 ◽

2020 ◽

Author(s):

Haonan Tian ◽

Congman Xie ◽

Min Lin ◽

Hongmei Yang ◽

Aishu Ren

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Mean Difference ◽

Controlled Trials ◽

Cochrane Central Register ◽

Canine Retraction ◽

Temporary Anchorage Devices ◽

The Mean ◽

Implant Anchorage

Abstract Background: Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods: A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs) . The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean difference s and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results: Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1. 56 mm , 95% CI: 1.14 to 1.98, P <0.00001 ) and the mandible (1.62 mm , 95% CI: 1.24 to 2.01, P <0.00001 ) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm , 95% CI: 0.16 to 0.69, P =0.001 ) and the mandible (0.26 mm , 95% CI: 0.02 to 0.49, P =0.03 ). Conclusions: There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed. Keywords: Orthodontic implants; Canine retraction; Systematic review; Meta-analysis

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Quetiapine immediate release v. placebo for schizophrenia: systematic review, meta-analysis and reappraisal

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.154377 ◽

2015 ◽

Vol 206 (5) ◽

pp. 360-370 ◽

Cited By ~ 5

Author(s):

Paul Hutton ◽

Peter J. Taylor ◽

Lee Mulligan ◽

Sarah Tully ◽

Joanna Moncrieff

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Weight Gain ◽

Meta Analysis ◽

Immediate Release ◽

Mean Difference ◽

Psychotic Symptoms ◽

Controlled Trials ◽

The Impact

BackgroundImmediate-release (IR) quetiapine has been used to treat schizophrenia since 1997, although all the principal placebo-controlled trials have >50% missing outcome data. New studies with relatively lower rates of participant withdrawal have since been published.AimsTo assess the efficacy and adverse effects of quetiapine IR for schizophrenia, with consideration of outcome quality and clinical meaningfulness of results, and to examine the potential impact of missing data on the main efficacy findings.MethodWe conducted a systematic review and meta-analysis of randomised controlled trials comparing quetiapine IR and placebo (or subtherapeutic dose in relapse prevention trials) for the treatment of schizophrenia (PROSPERO registration CRD4201100165). Primary outcomes were change in overall symptoms and response rates. We also examined whether high rates of participant withdrawal (⩾50%) attenuated effect sizes, and assessed the impact of making different assumptions about these people's outcomes.ResultsWe identified 15 relevant trials (including 2 unpublished), providing the first 12-week data for this drug and the first data on self-reported quality of life. We found quetiapine IR to have a weighted mean difference (WMD) of 6.5 points (95% CI −8.9 to −4) on Positive and Negative Syndrome Scale (PANSS) total scores, which corresponds to a standardised mean difference (SMD) of −0.33 (95% CI −0.46 to −0.21). Longer trials reported larger mean differences favouring quetiapine IR, but the overall estimate was smaller if more conservative assumptions about the outcomes of people who left the trial early were made. Approximately 21 people needed to take quetiapine IR for 1 person to experience at least a 50% improvement in PANSS score. No difference in quality of life was observed (two RCTs), although small to moderate improvements in social functioning were found (three RCTs). Quetiapine IR caused sedation and increased rates of clinically significant weight gain, but no extrapyramidal effects were observed.ConclusionsQuetiapine IR has a small beneficial effect on overall psychotic symptoms over 2–12 weeks, but also leads to weight gain and sedation.

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Effects of Phytoestrogen Supplement on Quality of Life of Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/3261280 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Ching-Ching Peng ◽

Chia-Yu Liu ◽

Nai-Rong Kuo ◽

Tao-Hsin Tung

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Randomized Controlled Trials ◽

Postmenopausal Women ◽

Meta Analysis ◽

Mean Difference ◽

Current Evidence ◽

Controlled Trials ◽

Randomized Controlled

Background. The effect of phytoestrogen on postmenopausal quality of life is unclear. This study evaluated the effects of phytoestrogen supplement on quality of life for postmenopausal women. Methods. We conducted a systematic review and meta-analysis of randomized controlled trials on the effects of phytoestrogen supplements on the quality of life of postmenopausal women. We searched PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials on March 31, 2018, for relevant randomized controlled trials. Two authors independently selected studies, assessed risk of bias, and extracted data. Disagreement was resolved through discussion with a third author. Results. We involved 10 articles in the systematic review. 8 studies and a total of 1,129 subjects were included in the meta-analysis. The questionnaires used in the evaluation of quality of life were as follows: SF-36, 4 studies; MENQOL, 4 studies; For Short Form 36 surveys, phytoestrogen groups scored significantly higher for body pain (mean difference = 3.85, 95% confidence interval [CI] = [1.14, 6.57], P < 0.01), mental health (mean difference = 4.01, 95% CI = [1.49, 6.57], P < 0.01), and role limitations caused by emotional problems domains (mean difference = 3.83, 95% CI = [1.81, 5.85], P < 0.01). No statistically significant difference was obtained from Menopause-Specific Quality of Life surveys (vasomotor domain mean difference 0.14, 95% CI = [−0.08, 0.36], P = 0.20; physical domain mean difference 0.20, 95% CI [−0.08, 0.48], P = 0.15; psychological domain mean difference −0.10, 95% CI [−0.26, 0.07], P = 0.27; sexual domain mean difference −0.17, 95% CI [−0.42, 0.09], P = 0.19). Conclusion. Current evidence does not support phytoestrogen supplementation improving postmenopausal quality of life. Further comprehensive trials or long-term follow-up studies are warranted.

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The Effectiveness of Pump Techniques and Pompages: A Systematic Review

Applied Sciences ◽

10.3390/app11094150 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4150

Author(s):

Carla Vanti ◽

Matteo Golfari ◽

Giacomo Pellegrini ◽

Alice Panizzolo ◽

Luca Turone ◽

...

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Risk Of Bias ◽

Walking Distance ◽

Blood Collection ◽

Controlled Trials ◽

Randomized Controlled ◽

Length Of Hospitalization

Background: Osteopathic manual procedures called pump techniques include thoracic, abdominal, and pedal pumps. Similar techniques, called pompages, are also addressed to joints and muscles. Despite their widespread use, no systematic review has been published on their effectiveness. (2) Methods: CINAHL, Cochrane Controlled Trials Register, ISI Web of Science, PEDro, PubMed, and Scopus databases were searched until July 2020. Randomized Controlled Trials (RCTs) on adults were included. Subjective (e.g., pain, physical function) and objective (e.g., pulmonary function, blood collection) outcomes were considered. The Risk of Bias tool (RoB 2) and the GRADE instrument were used to evaluate the quality of evidence. (3) Results: 25 RCTs were included: 20 concerning the pump techniques and five concerning pompages. Due to the extensive heterogeneity of such studies, it was not possible to perform a meta-analysis. The risk of bias resulted from moderate to high and the quality of the evidence was from very low to high. Singular studies suggested some effectiveness of pump techniques on pain and length of hospitalization. Pompage seems also to help improve walking distance and balance. (4) Conclusions: Although several studies have been published on manual pump techniques, the differences for population, modalities, dosage, and outcome measures do not allow definite conclusions of their effectiveness.

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Effectiveness of caregiver interventions for people with cancer and non-cancer-related chronic pain: a systematic review and meta-analysis

British Journal of Pain ◽

10.1177/20494637211022771 ◽

2021 ◽

pp. 204946372110227

Author(s):

Toby O. Smith ◽

Matthew Pearson ◽

Matthew J Smith ◽

Jessica Fletcher ◽

Lisa Irving ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Chronic Pain ◽

Confidence Interval ◽

Meta Analysis ◽

Informal Caregivers ◽

Mean Difference ◽

Caregiver Interventions ◽

Quality Evidence

Background: People with chronic pain frequently have difficulties in completing everyday tasks to maintain independence and quality of life. Informal caregivers may provide support to these individuals. However, the effectiveness of interventions to train and support these individuals in caregiving remains unclear. The purpose of this study was to systematically review the evidence to determine the effectiveness of caregiver interventions to support informal caregivers of people with chronic pain. Methods: A systematic review of published and unpublished literature databases was undertaken (9 April 2021). Trials reporting clinical outcomes of caregiver interventions to train informal caregivers to support community-dwelling people with chronic pain were included. Meta-analysis was undertaken and each outcome was assessed using Grading of Recommendations, Assessment, Development and Evaluation. Results: Twenty-seven studies were eligible (N = 3427 patients). Twenty-four studies assessed patients with cancer pain and three with musculoskeletal pain. No other patient groups were identified. There was very low-quality evidence that caregiver interventions were beneficial for caregiver health-related quality of life (standardised mean difference = 0.26, 95% confidence interval = 0.01 to 0.52; N = 231). There was moderate-quality evidence that caregiving interventions were effective in reducing pain in the short-term (standardised mean difference = 0.16, 95% confidence interval = −0.29 to −0.03). There was low-quality evidence that caregiving interventions had no beneficial effect over usual care for psychological outcomes, fatigue, coping or physical function in the long-term. Conclusion: Caregiving interventions may be effective for patients and caregivers but only in the shorter-term and for a limited number of outcomes. There is insufficient evidence examining the effectiveness of caregiver interventions for people with non-cancer-related pain.

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Effectiveness and safety of low-level laser therapy in diabetic peripheral neuropathy: a protocol for a systematic review and meta-analysis

Systematic Reviews ◽

10.1186/s13643-021-01656-y ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Lin Lin ◽

Jingjing Li ◽

Jingshan Lin ◽

Shiheng Tang ◽

Yuxia Li

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Meta Analysis ◽

Specific Treatment ◽

Risk Of Bias ◽

Low Level Laser Therapy ◽

Controlled Trials ◽

Medical Treatments ◽

Level Laser

Abstract Background Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes mellitus. The main symptoms of DPN include numbness or pain in both extremities and paresthesia (such as formication or burning sensations), which greatly affect patients’ quality of life. Pharmacological treatments for DPN are associated with both uncertain therapeutic effects and adverse effects, as well as with high costs. Some clinical studies have reported that low-level laser therapy (LLLT) relieves clinical symptoms and improves nerve function in patients with DPN. We intend to conduct a systematic review and meta-analysis to further evaluate the effectiveness and safety of LLLT for DPN. Methods The following electronic databases will be searched to retrieve literature from their inception until December 2020: MEDLINE (PubMed), Embase, Cochrane Central Register of Controlled Trials, Web of Science (the Science and Social Science Citation Index), CNKI, VIP, WanFang, and SinoMed. Simultaneously, clinical registration tests and gray literature will also be retrieved. Randomized controlled trials (RCTs) comparing LLLT with either sham LLLT, no (specific) treatment, or active conventional medical treatments will be included. The primary outcomes will be nerve conduction velocity as well as clinical scores that assess neurological function and related symptoms. The risk of bias of each study and quality of evidence will be assessed using the updated Cochrane Risk of Bias 2.0 tool and GRADE approach, respectively. A meta-analysis will then be conducted using Review Manager software version 5.3. Discussion This study will integrate RCTs and analyze data to provide a detailed summary of the evidence relating to the effects and safety of LLLT in patients with DPN. LLLT will be compared with sham LLLT, no (specific) treatment, or active conventional medical treatments, especially in terms of neurological function, quality of life, and adverse events. In conclusion, this systematic review will generate evidence regarding the use of LLLT to treat DPN, in terms of both its efficacy and safety. Systematic review registration This protocol was registered with the International Prospective Register of Systematic Reviews on April 2020 (registration number: CRD42020170625).

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A Low-FODMAP Diet Improves the Global Symptoms and Bowel Habits of Adult IBS Patients: A Systematic Review and Meta-Analysis

Frontiers in Nutrition ◽

10.3389/fnut.2021.683191 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jinsheng Wang ◽

Pengcheng Yang ◽

Lei Zhang ◽

Xiaohua Hou

Keyword(s):

Systematic Review ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Risk Of Bias ◽

Stool Frequency ◽

Stool Consistency ◽

Controlled Trials ◽

Irritable Bowel ◽

Fodmap Diet

Background: A low-fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet has been reported to be associated with improving the symptoms of irritable bowel syndrome (IBS); however, its efficacy as evaluated by different studies remains controversial.Objective: A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to explore the efficacy of a low-FODMAP diet (LFD) in alleviating the symptoms of IBS.Methods: A search of the literature for RCTs that assessed the efficacy of an LFD in treating IBS patients was conducted using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science. The searches in each database were conducted from the inception of the database to February 2021. Two independent reviewers screened citations and a third reviewer resolved disagreements. Two independent reviewers also performed eligibility assessments and data extraction. The RCTs that evaluated LFDs vs. a normal IBS or usual diet and assessed changes of IBS symptoms were included in the search. Data were synthesized as the relative risk of global symptoms improvement, mean difference of IBS Severity Scoring System (IBS-SSS) score, sub-items of IBS-SSS irritable bowel syndrome-related quality of life (IBS-QOL), hospital anxiety and depression scale (HADS), stool consistency/frequency, and body mass index (BMI) using a random effects model. The risk of bias was assessed using Risk of Bias Tool 2 (RoB 2). The bias of publication was assessed based on Egger's regression analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.Results: A total of 2,768 citations were identified. After full-text screening, a total of 10 studies were eligible for the systematic review and were subsequently used to compare an LFD with various control interventions in 511 participants. An LFD was associated with the improvement of global symptoms [n = 420; Risk Ratio (RR) = 1.54; 95% Confidence Interval (CI) 1.18 to 2; I2 = 38%], improvement of stool consistency [n = 434; Mean difference (MD) = −0.25; 95% CI −0.44 to −0.06; I2= 19%), and a reduction trend of stool frequency (n = 434; MD = −0.28; 95% CI −0.57 to 0.01; I2 = 68%) compared with control interventions. There was no statistically significant change in IBS-QOL (n = 484; MD = 2.77; 95% CI −2 to 7.55; I2 = 62%), anxiety score (n = 150; MD = −0.45; 95% CI −3.38 to 2.49; I2 = 86%), depression score (n = 150; MD = −0.05; 95% CI −2.5 to 2.4; I2 = 88%), and BMI (n = 110; MD = −0.22; 95% CI −1.89 to 1.45; I2 = 14%). The overall quality of the data was “moderate” for “global improvement of IBS symptom,” “stool consistency,” “stool consistency for IBS with diarrhea (IBS-D),” and “stool frequency for IBS-D,” and “low” or “very low” for other outcomes according to GRADE criteria.Conclusion: An LFD is effective in reducing the global symptoms and improving the bowel habits of adult IBS patients. The efficacy for IBS-D patients can also be more pronounced.Systematic Review Registration: CRD42021235843.

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The Clinical Efficacy of Phytochemical Medicines Containing Tanshinol and Ligustrazine in the Treatment of Stable Angina: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/8616413 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Li Gao ◽

Tong Wu ◽

Juan Wang ◽

Zhuoran Xiao ◽

Chunhua Jia ◽

...

Keyword(s):

Systematic Review ◽

Clinical Efficacy ◽

Stable Angina ◽

Meta Analysis ◽

Clinical Effectiveness ◽

Risk Of Bias ◽

Controlled Trials ◽

Randomized Controlled ◽

Better Than

Background. Phytochemical medicines containing tanshinol and ligustrazine are commonly used in the treatment of stable angina in China, but their clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the clinical efficacy. Methods. Relevant randomized controlled trials (RCTs) of phytochemical medicines containing tanshinol and ligustrazine in the treatment of stable angina were searched in electronic databases. The search date was up to March 31, 2020, and the languages of the RCTs were limited to English and Chinese. Results. A total of 28 studies, including 2518 patients, were included in the meta-analysis. It was shown that the adjunctive therapy of phytochemical medicines containing tanshinol and ligustrazine was better than the conventional therapies in the improvement of stable angina according to the clinical efficacy in symptoms (n = 2518, RR = 1.24, 95% CI: 1.20 to 1.29, P < 0.01 ) and clinical efficacy in electrocardiography (n = 1766, RR = 1.29, 95% CI: 1.19 to 1.40, P < 0.01 ). Conclusion. The meta-analysis supported the use of phytochemical medicines containing tanshinol and ligustrazine in the treatment of stable angina. However, quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed RCTs are still needed to further evaluate the efficacy.

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Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/241027 ◽

2013 ◽

Vol 2013 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Qin-hong Zhang ◽

Jin-huan Yue ◽

Ming Liu ◽

Zhong-ren Sun ◽

Qi Sun ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Significant Difference ◽

Cessation Of Treatment

Objectives. This study aims to assess the effectiveness and safety of moxibustion for the correction of nonvertex presentation.Methods. Records without language restrictions were searched up to February 2013 for randomized controlled trials (RCTs) comparing moxibustion with other therapies in women with a singleton nonvertex presentation. Cochrane risk of bias criteria were used to assess the methodological quality of the trials.Results. Seven of 392 potentially relevant studies met the inclusion criteria. When moxibustion was compared with other interventions, a meta-analysis revealed a significant difference in favor of moxibustion on the correction of nonvertex presentation at delivery (risk ratio (RR) 1.29, 95% confidence interval (CI) 1.12 to 1.49, andI2=0). The same findings applied to the cephalic presentation after cessation of treatment (RR 1.36, 95% CI 1.08 to 1.71, andI2=80%). A subgroup analysis that excluded two trials with a high risk of bias also indicated favorable effects (RR 1.63, 95% CI 1.42 to 1.86, andI2=0%). With respect to safety, moxibustion resulted in decreased use of oxytocin.Conclusion. Our systematic review and meta-analysis suggested that moxibustion may be an effective treatment for the correction of nonvertex presentation. Moreover, moxibustion might reduce the need for oxytocin.

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