Effects of noninvasive electroacupuncture on labor pain, adrenocorticotropic hormone, and cortisol.

CONTEXT: Labor pain is the most painful experience in a mother's life. Acupuncture has been reported to be useful for pain relief during labor. OBJECTIVE: The study was designed to assess the effects of noninvasive electroacupuncture at Hegu (LI4) on labor pain and on adrenocorticotropic hormone (ACTH) and cortisol levels. DESIGN: The study was randomized, with an experimental acupuncture group (AG) and a control group (CG). SETTING: The study was conducted at the Kayseri Maternity Hospital in Turkey, over a period of 6 months in 2010. PARTICIPANTS: Participants were women in the active phase of labor. INTERVENTION: For the acupuncture group (AG), bilateral, Hegu acupuncture points were stimulated using a transcutaneous electrical nerve stimulation (TENS) acupuncture pen for 20 min in total. The control group did not receive acupuncture. All women received routine and standard nursing care and treatments. PRIMARY OUTCOME MEASURES: Blood ACTH and cortisol levels and visual analogue scale (VAS) scores were compared between the AG and CG to evaluate the efficacy of acupuncture treatment. RESULTS: Blood ACTH and cortisol levels and VAS scores were lower in the AG than in the CG; however, these differences did not reach a statistically significant level. CONCLUSION: In this study, blood ACTH and cortisol levels and VAS scores were affected by electroacupuncture intervention on Hegu (LI4), although the result was not statistically significant.

Transient gestational diabetes insipidus diagnosed in successive pregnancies: review of pathophysiology, diagnosis, treatment, and management of delivery.

Gestational diabetes insipidus (GDI) is a rare disorder characterised by polyuria, polydypsia, and excessive thirst usually manifesting in the third trimester of pregnancy. The etiology is thought to depend on excessive vasopressinase activity, a placental enzyme that degrades arginine-vasopressin (AVP), but not 1-deamino-8-D: -arginine vasopressin (dDAVP), which is a synthetic form. This is a transient syndrome and may be associated with acute fatty liver of pregnancy and preeclampsia. The use of dDAVP in symptomatic cases has been proven as a safe method for both the mother and the fetus during the pregnancy. We report a case of recurrent gestational diabetes insipidus in successive pregnancies, which responded to dDAVP and subsided after delivery.