Please select the eligibility criteria that correspond to the clinical trial below.
Title: Battlefield Auricular Acupuncture for Control of Post-partum Pain
Brief Summary: We will conduct a randomized controlled trial to determine whether the addition of battlefield auricular acupuncture to standard of care is effective for control of postpartum pain for mothers in the immediate post-partum period. Post-partum patients (DoD beneficiaries) 18 years or older, regardless of gravida/parity, who plan to have a childbirth in a hospital setting will be offered the opportunity to participate in the study through PCM referrals and posted advertisements. After a minimum of 6 hours post-vaginal delivery or 24 hours post caesarean section subjects will be given treatment according to their randomization group. Subjects will be assessed on pain control, overall satisfaction with pain management, and the amount of pharmacological pain medications used. Safety of measures will also be assessed to include infection rates, syncope, vertigo, and hypotension.


Options:
A: Inclusion Criteria:

* Cesarean section at term (at least 39 weeks gestation) scheduled in advance
* Singleton gestation confirmed by ultrasound in the current pregnancy
* Body mass index 20-40 kg/m2 (at first prenatal visit or pre-pregnancy)
* None of these pregnancy complications in the current pregnancy:

  1. bleeding disorder or use of anticoagulants other than low-dose heparin
  2. abnormal placenta (placenta previa or accrete)
  3. Preoperative hemoglobin less than 10 mg/dL
  4. Chorioamnionitis (intrauterine infection)
* No chronic pain syndrome (defined as participating in formal chronic pain management within the past year)
* Able to read English and understand spoken English

Exclusion Criteria:

* Onset of labor prior to time when the cesarean was scheduled
* Complications during performance of cesarean or discovered during cesarean:

  1. placenta accreta, increta, or percreta
  2. vasa previa
  3. cesarean hysterectomy required for severe hemorrhage
  4. organ damage during cesarean (cystotomy, enterotomy, ureteral injury)
B: Inclusion Criteria:

* 18 years or older
* full term singleton pregnancy
* undergoing elective cesarean delivery

Exclusion Criteria:

* Patients who have refused, are unable to give or have withdrawn consent
* Patients unable to communicate fluently in English
* Patients with American Society of Anesthesiologists (ASA) classification of 3 or greater
* Patients with chronic pain, or neuropathic analgesic drugs
* Patients in use of antidepressant and psychotropic drugs
* Patients with a history of opioid or intravenous drug abuse
* Patients with known allergy or contra-indication to any other drugs used in this trial
* Patients who have refused spinal anesthesia, or those in whom it is contra-indicated
* Patients with a history of previous cesarean delivery and persistent pain
C: THIS STUDY IS BEING CONDUCTED AT A MILITARY INSTALLATION. YOU MUST HAVE MILITARY INSURANCE IN ORDER TO PARTICIPATE IN THIS STUDY.

Inclusion:

* Post-partum female (DoD beneficiaries).
* Age 18 years or older
* Pain score rating post-delivery of greater or equal to 4/10.

Exclusion:

* Absence of one or more ears
* Active cellulitis of ear
* Ear anatomy precluding identification of acupuncture landmarks
* Non-English speaking
* Use of Hearing Aids that preclude the use of ear acupuncture
* Known allergy to gold
D: Inclusion Criteria:

* Pregnant women undergoing cesarean delivery

Exclusion Criteria:

* Cesarean hysterectomy
* Intraoperative accidental injury to urinary or gastrointestinal organs
* Postoperative admission to intensive care unit (ICU)
* Postoperative intraperitoneal drain placement
* Unable to understand and follow oral/written instructions
* Severe neuromuscular or circulatory disorders
* Pulmonary diseases

Answer: C