Effect of Purslane seed Capsule in Prevention of Postpartum after pain in Multiparous Mothers: A Randomized Clinical Trial

Document Type : Original Article

Authors

1 M.Sc. Student of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Pharmacology, Pharmacologic and Medicinal Plants Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Instructor, Department of Nursing, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: After pain is one of the postpartum problems that sometimes requires analgesics to remove it, and its relief improves lactation and better communication between mother and baby. Pharmacological evalution of Purslane seed indicates the effect of this plant on pain adjustment and regulation. This study was performed with aim to determine the effect of purslane seed in preventionof after pain.
Methods: This triple-blind clinical trial study was conducted on 74 multiparous mothers in Shirvan city affiliated to North Khorasan University of Medical Sciences in 2018. The research units were randomly divided into two groups of purslane seed (n=37) and placebo (n=37). After completing third stage of delivery, one capsule of purslane seed or placebo was given to the research unit. The patients in both groups received analgesics if they had pain. After start of the intervention, the capsules were consumed every 8 hours (up to 4 doses). The score of after pain was measured after the intervention and one hour before and after the next doses using the visual analogue scale of pain. Data were analyzed using SPSS software (version 25) and Mann-Whitney, independent t-test, Fisher, and Chi-square tests. P<0.05 was considered statistically significant.
Results: After taking capsules, the intensity of after pain in the purslane seed group significantly decreased compared to the placebo group (p<0.001). The number of consumed analgesics in multiparous mothers of purslane seed group was significantly less than the placebo group (p<0.001).
Conclusion: Purslane seed is effective in reducing the intensity of after pain and preventing it, and it reduces the need for edible analgesics.

Keywords


  1. Tafazoli M, Khadem Ahmadabadi M, Asili J, Esmaili H. Comparison the effects of cuminum and mefenamic acid on after pains in multiparous women. Iran J Obstet Gynecol Infertil 2013; 16(75):1-11. (Persian).
  2. Huang YC, Tsai SK, Huang CH, Wang MH, Lin PL, Chen LK, et al. Intravenous tenoxicam reduces uterine cramps after Cesarean delivery. Can J Anesth 2002; 49(4):384-7.
  3. Yeh YC, Chen SY, Lin CJ, Yeh HM, Sun WZ. Differential analgesic effect of tenoxicam on post-cesarean uterine cramping pain between primiparous and multiparous women. J Formos Med Assoc 2005; 104(9):647-51.
  4. Bloomfield SS, Cissell GB, Peters NM, Mitchell J, Nelson ED, Barden TP. Anirolac vs. naproxen for postpartum uterine pain. Clin Pharmacol Ther 1987; 42(1):89-95.
  5. Cunningham FG, Leveno K, Bloom SL, Spong CY, Dashe J. Williams obstetrics. 24th ed. New York: McGraw-Hill; 2014. P. 799.
  6. Jangsten E, Bergh I, Mattsson LÅ, Hellström AL, Berg M. Afterpains: a comparison between active and expectant management of the third stage of labor. Birth 2011; 38(4):294-301.
  7. Kheiriyat F, Tadayon Najafabadi M, Mousavi P, Haghighizadeh H, Namjuyan F. Effect of Dill essence and mefenamic acid on postpartum pain. Iran J Obstet Gynecol Infertil 2016; 19(4):8-16. (Persian).
  8. Jangsten E, Strand R, Gomez de Freitas EG, Hellström A-L, Johansson A, Bergström S. Women's perceptions of pain and discomfort after childbirth in Angola. Afr J Reprod Health 2005; 9(3):148-58.
  9. Holdcroft A, Snidvongs S, Cason A, Doré CJ, Berkley KJ. Pain and uterine contractions during breast feeding in the immediate post-partum period increase with parity. Pain 2003; 104(3):589-96.
  10. Matteson P. Women's health during the childbearing years: a community-based approach. New York: Mosby; 2001.
  11. Deussen AR, Ashwood P, Martis R. Analgesia for relief of pain due to uterine cramping/involution after birth. Cochrane Database Syst Rev 2011; 5:CD004908.
  12. Eisenach JC, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain 2008; 140(1):87-94.
  13. Dox IG, Melloni JL, Sheld HH. Melloni's illustrated dictionary of obstetrics and gynecology. Abingdon: Taylor & Francis; 2000.
  14. Chananeh M, Janati Ataei P, Dolatian M, Mojab F, Nasiri M. Effects of the combination of nigella sativa and mefenamic acid and mefenamic acid alone on the severity of postpartum pain in multiparous women: a double-blind clinical trial. Iran J Obstet Gynecol Infertil 2018; 21(4):62-71. (Persian).
  15. Lewallen LP, Dick MJ, Wall Y, Zickefoose KT, Hannah SH, Flowers J, et al. Toward a clinically useful method of predicting early breast-feeding attrition. Appl Nurs Res 2006; 19(3):144-8.
  16. Ogunfowokan AA, Babatunde OA. Management of primary dysmenorrhea by school adolescents in ILE-IFE, Nigeria. J Sch Nurs 2010; 26(2):131-6.
  17. Abedian Z, Rezvani Fard M, Asili J, Esmaeili H, Dadgar S. Comparison of the effect of chamomile matricaria and mefenamic acid capsules on postpartum hemorrhage in women with postpartum pain. Iran J Obstet Gynecol Infertil 2016; 19(14):1-8. (Persian).
  18. Mahdavian M, Golmakani N, Mansoori A, Hoseinzadeh H, Afzalaghaee M. An investigation of effectiveness of oral Dill extracts on postpartum hemorrhage. J Women Midwifery Infertil Iran 2001; 78(4):19-26.
  19. Keshavarzi K, Moradi M, Khoshnam S, Alvani A, Safaei Pour Zamani M, Fatahi M, et al. Evaluation the effect of hydro-alcoholic extract of portulaca oleracea and estradiol on pain threshold in female mice. J Med Plants 2017; 2(62):29-37.
  20. Parsa L, Ozgoli G. A systematic on the medicinal plants used in the treatment of postpartum pain in Iran. Iran J Obstet Gynecol Infertil 2017; 20(5):84-96. (Persian).
  21. Zarei A, Ashtiyani SC, Taheri S. The effect of the extract of portulaca oleracea on physiological. Qom Univ Med Sci J 2015; 8:5. (Persian).
  22. Iranshahy M, Javadi B, Iranshahi M, Jahanbakhsh SP, Mahyari S, Hassani FV, et al. A review of traditional uses, phytochemistry and pharmacology of Portulaca oleracea L. J Ethnopharmacol 2017; 205:158-72.
  23. Zhou YX, Xin HL, Rahman K, Wang SJ, Peng C, Zhang H. Portulaca oleracea L.: a review of phytochemistry and pharmacological effects. Biomed Res Int 2015; 2015:925631.
  24. Bahmani M, Shirzad H, Majlesi M, Shahinfard N, Rafieian-Kopaei M. A review study on analgesic applications of Iranian medicinal plants. Asian Pac J Trop Med 2014; 7:S43-53.
  25. Uddin MK, Juraimi AS, Hossain MS, Nahar MA, Ali ME, Rahman M. Purslane weed (Portulaca oleracea): a prospective plant source of nutrition, omega-3 fatty acid, and antioxidant attributes. Sci World J 2014; 2014:951019.
  26. Chowdhary CV, Meruva A, Elumalai RK. A review on phytochemical and pharmacological profile of portulaca oleracea linn (Purslane). Int J Res Ayurveda Pharm 2013; 4:1.
  27. Uddin MK, Juraimi AS, Ismail MR, Brosnan JT. Characterizing weed populations in different turfgrass sites throughout the Klang Valley of Western Peninsular Malaysia. Weed Technol 2010; 24(2):173-81.
  28. Wenzel GE, Fontana J, Correa JB. The viscous mucilage from the weed Portulaca oleracea, L. Appl Biochem Biotechnol 1990; 24(1):341-53.
  29. Mirzaei N, Moghaddam FS, Ozgoli G, Sahranavard S, Ghasemi E. Purslane (Portulaca oleracea) effect on heavy menstrual bleeding (menorrhagia) in Iranian women. Adv Integr Med 2017; 5(2):56-62.
  30. Shobeiri S, Sharei S, Heidari A, Kianbakht S. Portulaca oleracea L. in the treatment of patients with abnormal uterine bleeding: a pilot clinical trial. Phytother Res 2009; 23(10):1411-4.
  31. Dong Z, Li C, Hong M, Shi Y. Effects of uterus contraction of the isolated mouse by the Motherwort and purslane compatibility. Chin J Basic Med Traditional Chin Med 2012; 9:24.
  32. Shojaii A, Dabaghian FH. Management of breastfeeding problems in Iranian traditional medicine. Iran J Public Health 2013; 42(11):1331-2.
  33. Dweck A. Purslane (Portulaca oleracea)-the global panacea. Perso Care Magnag 2013; 2(4):7-15.
  34. Bosi G, Guarrera PM, Rinaldi R, Bandini Mazzanti M. Ethnobotany of purslane (Portulaca oleracea L.) in Italy and morfo-biometric analyses of seeds from archaeological sites of Emilia Romagna (Northern Italy). Plants and culture: seeds of the cultural heritage of Europe. Bari, Italy: Edipuglia; 2009. P. 129-39.
  35. Xu Z, Shan Y. Anti-fatigue effects of polysaccharides extracted from Portulaca oleracea L. in mice. Indian J Biochem Biophys 2014; 51(4):321-5.
  36. Park SJ, Choi MJ, Kim JW, Choi SH. The involvement of AMPA receptor in the antidepressant-like effects of the portulaca oleracea L. extract in mice. J Oriental Neuropsychiatry 2013; 24(3):271-80.
  37. Mokhtarifar A, Zeydabadi FA, Asili J, Kooshyar MM, Sahebkar A. The effect of Portulaca oleracea (purslane) seeds on hemoglobin levels in adolescent girls with iron deficiency anemia: a randomized comparative trial. Compar Clin Pathol 2017; 26(1):11-6.
  38. Dong L, Wang W, Yue Y, Li M. Effects of flavones extracted from Portulaca oleracea on ability of hypoxia tolerance in mice and its mechanism. Zhong Xi Yi Jie He Xue Bao 2005; 3(6):450-4.
  39. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain 2011; 152(10):2399-404.
  40. Farrar JT, Troxel AB, Stott C, Duncombe P, Jensen MP. Validity, reliability, and clinical importance of change in a 0—10 numeric rating scale measure of spasticity: a post hoc analysis of a randomized, double-blindŲŒ placebo-controlled trial. Clinical therapeutics. 2008;30(5):974-85.
  41. Hajzadeh M, Rakhshandeh H, Esmaeilizadeh M, Ghorbani A. Analgesic and anti-inflammatory effects of Portolaca oleracea extracts in mice & rat. Koomesh. 2004;5(3):113-20.
  42. Sayyah M, Malayeri AR, Seiahpoosh A, Samaee HR, Moameni M, Tahmasbi M. Efficacy evaluation of portulaca oleracea L. in control of the opium with drawal symptoms. J Med Plants 2011; 4(40):33-8.
  43. Pourmaleky S, Najar S, Montazery S, Haghighizadeh MH. Comparison between the effects of Zintoma (Ginger) and Mefenamic acid on after pain during postpartum in multiparous women. Iran J Obstet Gynecol Infertil 2013; 16(79):18-25. (Persian).
  44. Rao BM, Kavitha R, Subash KR, Rao NJ. Evaluation of anti arthritic activity of pet–ether extract of portulaca oleracea (Linn.). Int J Appl Biol Pharm Technol 2012; 3(3):144-8.
  45. Nijveldt RJ, Van Nood EL, Van Hoorn DE, Boelens PG, Van Norren K, Van Leeuwen PA. Flavonoids: a review of probable mechanisms of action and potential applications. Am J Clin Nutr 2001; 74(4):418-25.
  46. Farhadpour F, Alvany A, Khakpour B, Ahmadi R, Mahdavi E. The effects of portulaca oleracea seed hydroalcoholic extract on pain threshold. Bio Med Sci 2014; 10:80-1.
  47. Obeng HO, Schwartz B, Plahar WA. Can leafy vegetable source of Omega-3 fatty acids ameliorate acute intestinal inflammation induced in mice? Case study of purslane (Portulaca oleracea). Eur J Med Plants 2015; 6(2):70-81.
  48. Yang X, Yan Y, Li J, Tang Z, Sun J, Zhang H, et al. Protective effects of ethanol extract from Portulaca oleracea L on dextran sulphate sodium-induced mice ulcerative colitis involving anti-inflammatory and antioxidant. Am J Transl Res 2016; 8(5):2138-48.
  49. Niazi A, Yousefzadeh S, Rakhshandeh H, Esmaeili H. Comparison of purslane cream and lanolin on nipple pain among breastfeeding women: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2018; 20(12):77-85. (Persian).
  50. Ozgoli G, Khodadadie A, Sheikhan Z, Jambarsang S, Mojab F, Taleb S. Comparison of efficacy between herbal capsule of anise and mefenamic acid on after-pain. J Med Plants 2017; 2(62):38-49.