Effects of Acupuncture on Labor Progression in Term Pregnancies with Prelabor Rupture of Membranes: A Randomized Controlled Trial

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Introduction: Prelabor rupture of membranes (PROM) at term increases the risk of maternal and neonatal complications. While expectant management aims to allow spontaneous labor, it can lead to infection, whereas active management may result in unnecessary interventions. Acupuncture (ACU) has been suggested as a nonpharmacological method to promote labor onset and reduce the need for induction. This randomized controlled trial aimed to assess the efficacy of ACU in women with PROM at ≥37 weeks’ gestation. Materials and Methods: Eligible women with singleton pregnancies, negative Group B Streptococcus swab, and reassuring maternal-fetal conditions were randomly assigned to receive either ACU or observation after a 6-h latency period. A total of 138 women were analyzed (69 per group). ACU treatment involved point selection based on Traditional Chinese Medicine to stimulate uterine activity and reduce anxiety. The primary outcome was the rate of labor induction; secondary outcomes included labor duration, time from PROM to labor/delivery, and delivery outcomes. Results: The induction rate did not significantly differ between groups (49.2% in ACU versus 60.8% in controls; p = 0.172). However, ACU significantly reduced the time from PROM to labor onset and delivery and the time from induction to delivery. These differences, however, lost significance after adjustment for confounding variables. In a subgroup analysis of women undergoing labor induction, ACU significantly reduced the induction-to-delivery interval ( p = 0.01). No differences were found in cesarean section rates, operative deliveries, epidural requests, or neonatal outcomes. No adverse events related to ACU were reported. Conclusions: This study suggests that ACU may not reduce the need for labor induction in PROM at term but could shorten labor duration in women undergoing induction. Further larger, powered trials are needed to confirm these findings and better define the role of ACU in obstetric care.

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