A narrative review from 2016 comprehensively examined the clinical efficacy of OMT for gynecological and obstetric conditions. Specifically, back pain and lower back function during pregnancy, pain and medication use during labor and delivery, infertility and subfertility, dysmenorrhea, (peri-)menopausal symptoms, and pelvic pain were investigated under treatment with an osteopathic manipulative technique. The efficacy for pregnancy-related back pain was demonstrated with statistical significance. Furthermore, a high-quality RCT study provided evidence for reduced medication use during childbirth through treatment with OMT.
If you are interested in the exact data:
Methods: A total of data from 24 studies involving 1,840 patients were included in the review. In addition to randomized controlled trials, other study designs, such as observational studies, were included in the analysis. The selection of databases was comprehensive, and the Cochrane Risk of Bias Tool was used to reflect the risk of bias. Due to differences in study designs, outcomes, and high heterogeneity, no meta-analysis could be performed.
Results:
1. Pregnancy-related back pain
The sample size for pregnancy-related back pain included 914 patients. As outcomes, a significant improvement in quality of life was observed in 453 patients, and a significant reduction in pain in 514 patients. Furthermore, the included studies showed a reduced risk of meconium staining of the amniotic fluid, a decrease in the preterm birth rate, and a reduction in the use of forceps.
2. Labor and delivery
In a total of 579 patients, the outcomes “reduction of pain during labor” and “reduction of medication use during delivery” were considered. Unlike the pregnancy-related pain, the studies here were very heterogeneous, making a statistical assessment of OMT during labor and delivery impossible. Nevertheless, a reduction in pain and analgesic consumption during labor, as well as significantly lower rates of cesarean sections, perineal tears, and episiotomies, were observed. Furthermore, treatment with OMT during labor could prevent a cesarean section and facilitate a natural birth.
3. Additional gynecological parameters
The following section describes further positive effects of OMT on various gynecological parameters which, in the absence of statistical significance, should be regarded only as initial indications. For example, the conception rate increased slightly and sex hormone levels changed after treatment with OMT. In addition, reductions in menstrual pain and analgesic use during menstruation were observed. OMT also provided relief from (peri-)menopausal symptoms during menopause. Finally, an improvement in pelvic pain should be mentioned. As stated above, these results are to be interpreted only as preliminary, positive indications that still need to be confirmed in studies with larger sample sizes and greater methodological homogeneity. Overall, the authors recommend further investigations with more pragmatic methodology, better and more detailed descriptions of the interventions, and systematic reporting of adverse events in order to obtain robust and generalizable results on the effectiveness of osteopathic manipulative treatment for gynecological and obstetric conditions (Ruffini et al. 2016).References:Ruffini N, D’Alessandro G, Cardinali L, et al. Osteopathic manipulative treatment in gynecology and obstetrics: A systematic review. Complement Ther Med. 2016;26:72-78
