Integrating Acupuncture for Preeclampsia with Severe Features and HELLP Syndrome in a High-Risk Antepartum Care Setting

Effects of Auriculotherapy on Gestational Hypertension: Randomized Controlled Trial Study

Background

This study aims to observe how auriculotherapy acts as a nonpharmacological treatment for pregnant women's gestational hypertension.

Materials and Methods

This study was a randomized controlled trial. Eighty patients were with gestational hypertension recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group just received the usual perinatal care. The intervention group received one month of auriculotherapy in addition to the usual care. Blood pressure was measured before and 15 minutes after rest in both groups twice a week. The data were analyzed using descriptive statistics and inferential tests.

Results

The mean systolic blood pressure, based on the Mann-Whitney test, was not statistically significant between the two groups before the intervention and in the first two weeks after the intervention (p >0.05); however, after the third week of intervention, the mean systolic blood pressure in the intervention group was significantly lower than that in the control group (p <0.001). As per the Mann-Whitney test, the mean diastolic blood pressure was not statistically significant between the two groups before the intervention and the first week after the intervention (p <0.05). However, after the second week of intervention, the mean diastolic blood pressure in the intervention group was significantly lower than that in the control group, and this decrease was highest in the fourth week of the intervention (p <0.001).

Conclusions

This study demonstrated that auriculotherapy would reduce blood pressure in pregnant women suffering from hypertension.

Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review

Background

Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. The management of preeclampsia has not changed much in more than two decades, and its aetiology is still not fully understood. Case reports and case series have traditionally been used to communicate new knowledge about existing conditions. Whether this is true for preeclampsia is not known.

Objective

To determine whether recent case reports or case series have generated new knowledge and clinical discoveries about preeclampsia.

Methods

A detailed search strategy was developed in consultation with a medical librarian. Two bibliographic databases were searched through Ovid: Embase and MEDLINE. We selected case reports or case series published between 2015 and 2020, comprising pregnant persons diagnosed with hypertensive disorders of pregnancy, including preeclampsia. Two reviewers independently screened all publications. One reviewer extracted data from included studies, while another conducted a quality check of extracted data. We developed a codebook to guide our data extraction and outcomes assessment. The quality of each report was determined based on Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series.

Results

We included 104 case reports and three case series, together comprising 118 pregnancies. A severe presentation or complication of preeclampsia was reported in 81% of pregnancies, and 84% had a positive maternal outcome, free of death or persistent complications. Only 8% of the case reports were deemed to be of high quality, and 53.8% of moderate quality; none of the case series were of high quality. A total of 26 of the 107 publications (24.3%) included a novel clinical discovery as a central theme.

Conclusion

Over two-thirds of recent case reports and case series about preeclampsia do not appear to present new knowledge or discoveries about preeclampsia, and most are of low quality.

The Role of Research in Guiding Treatment for Women's Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists

Background: Surveys of acupuncture practitioners worldwide have shown an increase in the use of acupuncture to treat women’s health conditions over the last ten years. Published studies have explored the effectiveness of acupuncture for various conditions such as period pain, fertility, and labor induction. However, it is unclear what role, if any, peer-reviewed research plays in guiding practice. Methods: Acupuncturists with a significant women’s health caseload were interviewed online in three small groups to explore factors that contribute to acupuncturists’ clinical decision made around treatment approaches and research. Results: Eleven practitioners participated in the focus groups. The overarching theme that emerged was one of ‘Not mainstream but a stream.’ This captured two themes relating to acupuncture as a distinct practice: ‘working with what you’ve got’ as well as ‘finding the right lens’, illustrating practitioners’ perception of research needing to be more relevant to clinical practice. Conclusions: Acupuncture practitioners treating women’s health conditions reported a disconnect between their clinical practice and the design of clinical trials, predominantly due to what they perceived as a lack of individualization of treatment. Case histories were popular as a learning tool and could be used to support increasing research literacy.