Iraqi doctors use acupuncture during drug shortage

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Iraqi doctors faced with a shortage of drugs in a capital city hit by years of conflict have successfully used acupuncture to treat mothers during caesarean section births.

Reporting on Thursday on a small study of 200 cases at a Baghdad hospital, the doctors said their results suggested the ancient Chinese technique could also be a useful addition to standard medical practice in fully equipped hospitals.

The doctors used acupuncture, where fine needles are inserted into certain points on the body, to see if they could replace or reduce the need for a drug called oxytocin which is often given to mothers just after a c-section delivery to help the womb contract and to cut the risk of bleeding. Oxytocin is a hormone that also occurs naturally in the body during labour.

The study covered emergency caesarean section at the Red Crescent Hospital for Gynecology and Obstetrics in Baghdad between 2004 and 2006, when oxytocin stocks were low.

“Oxytocin ... proved largely unnecessary in my series (of patients), apparently through the action of acupuncture,” Lazgeen Zcherky, an anaesthetist who led the study, said in a statement. “We were thus able to conserve stocks of those drugs we held in short supply without ill effects on our patients.”

Acupuncture is one of the most widely practised strands of alternative medicine and is based on the theory that inserting and manipulating fine needles at specific points in the body helps to promote the flow of “Qi” or energy.

It has its origins in ancient China and has become widely accepted in the West in recent decades, particularly in the treatment of pain. It is also used for conditions like obesity, constipation and arthritis, among others, although documented scientific evidence for these areas is patchy.

In the Baghdad study, six acupuncture needles were inserted as soon as possible after delivery into the mother’s toes and ankles and manually stimulated for five to 10 minutes.

The acupuncture points related to bleeding from the womb, prolapse of the womb, difficult labour, uterine contractions, and retention of the placenta, the doctors wrote in the study in Acupuncture in Medicine, a British Medical Journal title.

The results showed that in 45 percent of the women, womb contraction was deemed to be enough not to need any oxytocin, and a further 30 percent of women needed two units of the drug.

The standard level of oxytocin used is normally between 10 to 20 units, Zcherky said, but in these patients only about 18 percent needed two to five units of oxytocin and only four women needed more than five units.

“These acupuncture techniques, born out of necessity, have proved useful in overcoming the deficiency of modern drugs and equipment in a war-torn city,” Zcherky said.

But Edzard Ernst, professor of complementary medicine at Britain’s Peninsula Medical School said Zcherky’s study was “misleading”.

“The fact is that, until fairly recently, women gave birth without medication or acupuncture and, in some parts of the world, they still do,” he wrote in an emailed comment.

“Several controlled clinical trials of acupuncture during childbirth do exist—and these data do not support the use of acupuncture.”

Separate research published on Wednesday found scant evidence that acupuncture helped ease labour pain, although it also found the technique seemed to do no harm.

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By Kate Kelland
LONDON (Reuters)

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