Original Contribution  |   October 2019
Does Compression of the Fourth Ventricle Cause Preterm Labor? Analysis of Data From the PROMOTE Study
Author Notes
  • From the University of North Texas Health Science Center in Fort Worth. This manuscript was prepared in partial fulfillment of the requirements to earn the designation of Fellow of the American Academy of Osteopathy (FAAO) for Dr Hensel. 
  • Disclaimer: Dr Hensel, a JAOA associate editor, was not involved in the editorial review or decision to publish this article. 
  • Financial Disclosures: None reported. 
  • Support: This study was supported by grants number K23AT003304 and K23AT3304-4S1 from the National Center for Complementary and Alternative Medicine at the National Institutes of Health and grant number 06-11-549 from the American Osteopathic Association. Additional financial support was provided by the Medical Education Foundation of the American College of Osteopathic Obstetricians and Gynecologists, the American Academy of Osteopathy, the Osteopathic Heritage Foundations, and the Osteopathic Research Center at the University of North Texas Health Science Center. It was also supported by the UNT Health Department of Obstetrics and Gynecology and FOR HER. 
  •  *Address correspondence to Kendi L. Hensel, DO, PhD, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, Texas 76107-2644. Email: kendi.hensel@unthsc.edu
     
Article Information
Obstetrics and Gynecology / Osteopathic Manipulative Treatment / Osteopathic Cranial Manipulative Medicine
Original Contribution   |   October 2019
Does Compression of the Fourth Ventricle Cause Preterm Labor? Analysis of Data From the PROMOTE Study
The Journal of the American Osteopathic Association, October 2019, Vol. 119, 668-672. doi:https://doi.org/10.7556/jaoa.2019.114
The Journal of the American Osteopathic Association, October 2019, Vol. 119, 668-672. doi:https://doi.org/10.7556/jaoa.2019.114
Abstract

Background: The technique for the compression of the fourth ventricle (CV4) in the brain has been described as a method of reaching the physiologic centers that reside in its floor and of restoring optimal flow of the cerebrospinal fluid. However, a study published as an abstract in 1992 questioned whether CV4, when applied to pregnant women, could induce uterine contractions and possibly labor.

Objective: To further examine whether CV4 could induce uterine contractions and labor as part of the osteopathic manipulative treatment (OMT) protocol used in the Pregnancy Research in Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE) study.

Methods: Labor and delivery data collected during the PROMOTE study from 2007-2011 were analyzed. The PROMOTE study was funded by the National Institutes of Health and was a randomized controlled clinical trial that measured the primary outcomes of back-specific functioning and pain in pregnant women aged 18 to 34 years. Participants were randomly divided into 3 groups—usual obstetric care only, placebo ultrasound treatment plus usual obstetric care, and OMT plus usual obstetric care. Study participants were scheduled for 7 treatment visits. Presented data were gathered from labor and delivery records.

Results: Four hundred participants were included. No significant differences were identified between treatment groups for the development of high-risk status (P=.293) or preterm delivery (P=.673). Evaluation of high-risk status by preterm delivery for the groups also showed no significant differences between groups (P=.455).

Conclusion: The application of CV4 as part of an OMT protocol during the third trimester caused neither a higher incidence of preterm labor nor the development of high-risk status.

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