Torkzahrani Shahnaz, Ghobadi Khadighe, Heshmat Reza, Shakeri Nezhat, Jalali Aria Katayoun
Department of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Counseling and Reproductive Health Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran ; Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Iran Red Crescent Med J. 2015 Aug 24;17(8):e28691. doi: 10.5812/ircmj.28691. eCollection 2015 Aug.
Cervical ripening is one of the main stages of initiation labor. Acupressure in Chinese medicine is considered as an invasive technique, which through reliving oxytocin ripens the cervix. Acupoint Sanyinjiao (SP6) was selected in this study because it is the acupoint selected in gynecology and it is easy for women to locate and apply pressure without medical assistance.
The aim of this study was to determine the effect of acupressure on cervical ripening.
In this randomized clinical trial, 150 primigravida with term pregnancy who had referred to Deziani hospital in Gorgan were chosen and divided to three groups: in the first group acupressure was done by the researcher while in the second groups this was performed by the mother her self, and the third group served as a control and only received routine care. For both intervention groups the pressure was applied on Sp6 for about 20 minutes during one to five days. Elements were checked from cervical ripening at 48 and 96 hours after intervention and at the time of hospitalization. The tools for gathering information included demographic characteristics and midwifery history questionnaire, daily records and follow up forms. Content validity was used for validity of tools. Reliability of the observation check-list and physical examination was confirmed by inter-rater scores (inter observer), and daily records by test-re-test. Data was analyzed by analysis of variance (ANOVA), Kruskal-Wallis and Chi-squared tests (P ≤ 0.05).
There was a significant difference between mothers' educations in the three groups. Most of the mothers (59.5%) in the researcher-performed acupressure group had secondary education. Cervical ripening was significantly different between the three groups after 48 hours (P ≤ 0.05), yet there was no significant difference after 96 hours and at the time of admission. Mean Bishop score was enhanced after 48 hours in the researcher-performed acupressure group (P ≤ 0.021) and the self-performed acupressure group (P ≤ 0.007) in comparison to the control group.
The results showed that acupressure is a safe technique and leads to cervical ripening. Thus, regarding the desired results that were achieved when mothers applied acupressure themselves, it could be suggested that it is beneficial for mothers to be trained to apply this method at home.
宫颈成熟是启动分娩的主要阶段之一。中医中的指压法被认为是一种侵入性技术，它通过释放催产素来使宫颈成熟。本研究选择三阴交穴（SP6），因为它是妇科常用穴位，女性在无需医疗协助的情况下易于定位和按压。
本研究的目的是确定指压法对宫颈成熟的影响。
在这项随机临床试验中，选取了150名足月妊娠的初产妇，她们均转诊至戈尔甘的德齐亚尼医院，并被分为三组：第一组由研究人员进行指压，第二组由母亲自行进行指压，第三组作为对照组，仅接受常规护理。对于两个干预组，在1至5天内对SP6施加压力约20分钟。在干预后48小时和96小时以及住院时检查宫颈成熟的各项指标。收集信息的工具包括人口统计学特征和助产史问卷、每日记录和随访表格。采用内容效度来评估工具的有效性。观察检查表和体格检查的可靠性通过评分者间得分（观察者间）得到确认，每日记录通过重测法得到确认。数据采用方差分析（ANOVA）、Kruskal-Wallis检验和卡方检验进行分析（P≤0.05）。
三组母亲的教育程度存在显著差异。研究人员进行指压组的大多数母亲（59.5%）接受过中等教育。干预后48小时，三组之间的宫颈成熟情况存在显著差异（P≤0.05），但96小时和入院时无显著差异。与对照组相比，研究人员进行指压组（P≤0.021）和自行指压组（P≤0.007）在干预后48小时的平均 Bishop 评分有所提高。
结果表明指压法是一种安全的技术，可导致宫颈成熟。因此，鉴于母亲自行进行指压时取得了理想的效果，建议对母亲进行培训，使其能够在家中应用这种方法。
