The effect of Plantago major cream on intensity of pain and episiotomy wound healing in nulliparous women

Document Type : Original Article

Authors

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

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

3 Ph.D. of Drug Control, Department of Pharmaceutical Sciences in Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Brigand University of Medical Sciences, Brigand, Iran.

5 Assistant Professor, Department of Epidemiology, Research Center for Social Determinants of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: One of the medical interventions in childbirth is episiotomy which is used to widen the pelvic outlet. Plantago is one of the oldest medicinal plants that have wound healing properties due to its flavonoids and phenolic compounds. The present study was performed aimed to determine the effect of plantago cream on intensity of pain and episiotomy wound healing in nulliparous women.
Methods: This triple-blind clinical trial study was performed in 2019 on 107 nulliparous women who had referred to Valiasr Hospital in Birjand for natural childbirth. The participants were randomly divided into two groups of placebo and drug. After delivery, mothers used 2-3 cm of prescribed cream on the sutures for 10 days and twice a day. The wound healing rate was evaluated on the third, seventh and tenth days after delivery using the Reda tool. Data were analyzed using SPSS 21 software and Chi-square and Mann-Whitney tests. P< 0.05 was considered statistically significant.
Results: The mean of Reda score in the drug group was 3.433 ± 0.635 on the third day, and 0.773 ± 0.422 on the seventh day, but in the placebo group, it was 5.611 ± 0.492, 2.185 0 0.478, respectively. The two groups had significant difference on the third and seventh days in terms of wound healing (p<0.001).  The median McGill score in the drug group was 26 on the third day and 7 on the seventh day, but in the placebo group, it was 44 and 19, respectively, and the two groups had a statistically significant difference in terms of pain intensity on the third and seventh day (P<0.001)
Conclusion: The use of plantago cream in comparison with placebo increases the speed of improvement of pain intensity and episiotomy wound healing in nulliparous women.

Keywords

References

  1. Desai P. Current Practice Obstetrics Gynecology. Jaypee Brothers, Medical Publishers; 2009.
  2. Malekpour PA. The effect of Turmeric in pain intensity and wound healing of episiotomy among primiparous Iranian women (Dissertation). Tabriz: Tabriz University of Medical Science; 2010.
  3. Drife JO, Magowan B, editors. Clinical obstetrics and gynaecology. Elsevier Health Sciences; 2004.
  4. Azhari S, Aradmehr M, Rakhshandeh H, Tara F, Shakeri MT. The effects of chamomile cream on wound healing of episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(93):16-26.
  5. Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and factors associated with episiotomy in Shahroud City, northeast of Iran. Int J Womens Health Reprod Sci 2016; 4(3):125-9.
  6. Jahdi F, Sheikhan F, Marghati KE, Haghani H. The effect of lavender essence on the post-episiotomy pain intensity of perineum. Journal of Sabzevar University of Medical Sciences 2009; 16(3):127-133.
  7. Lazarus GS, Cooper DM, Knighton DR, Margolis DJ, Percoraro RE, Rodeheaver G, et al. Definitions and guidelines for assessment of wounds and evaluation of healing. Wound repair and regeneration 1994; 2(3):165-70.
  8. Yari F. The effect of lidocaine 2% and gel Lidocaine 2% during episiotomy on pain perineal area of the city of Khorramabad in primiparous women (Doctoral dissertation, Thesis in Persian]. Mashhad: School of Nursing and Midwifery of Mashhad University of Medical Sciences); 1999.
  9. Golmakani N, Rabiei Motlagh E, Tara F, Assili J, Shakeri MT. The effects of turmeric (Curcuma longa L) ointment on healing of episiotomy site in primiparous women. Iran J Obstet Gynecol Infertil 2008; 11(4):29-39.
  10. Azar F, Zahery F, Khamneh S, Mohammad Alizadeh S, Koushavar H. The Efficacy Of 2% Lidocaine Gel In Healing The Episiotomy And Relieving Its Pain During Postpartum. Journal of Ardabil University of Medical Sciences (Jaums); 2006; 6(1):61-66.
  11. Albers LL, Sedler KD, Bedrick EJ, Teaf D, Peralta P. Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: a randomized trial. Journal of midwifery & women's health 2005; 50(5):365-72.
  12. Kamondetdecha R, Tannirandorn Y. Ibuprofen versus acetaminophen for the relief of perineal pain after childbirth: a randomized controlled trial. Medical journal of the Medical Association of Thailand 2008; 91(3):282.
  13. Mahdavian M, Golmakani N, Mansoori A, Hoseinzadeh H, Afzalaghaee MJ. An investigation of effectiveness of oral Dill extracts on postpartum hemorrhage. J Women Midwifery Infertil Iran 2001; 78(4):19-26.
  14. Malekizade M, Rakhshande H, KHhajedeloee M, KHhadivzadeh T. Evaluation of lavender cream effect on Perineal Pain and episiotomy wound healing in Primiparous Women. Mashhad Univ Med SciUMS 2009; 9(1):19-24.
  15. Emami A, Ahi A. Medicinal phytology. Mashhad University of Medical Sciences; 2012.
  16. Ravi R, Somani SM, Rybak LP. Mechanism of cisplatin ototoxicity: antioxidant system. Pharmacology & toxicology 1995; 76(6):386-94.
  17. Türel I, Özbek H, Erten R, Öner AC, Cengiz N, Yilmaz O. Hepatoprotective and anti-inflammatory activities of Plantago major L. Indian journal of pharmacology 2009; 41(3):120.
  18. Phipps M, Mahmood A. Gastroprotective activity of P. Major in rats. Int J Trop Med 2006; 1:36-9.
  19. Machin D, Campbell MJ, Fayers P, Pinol A. Sample Size Tables for Clinical Studies. 2nd Blackwell Science; 1997.
  20. Atta AH, Nasr SM, Mouneir SM. Potential protective effect of some plant extracts against carbon tetrachloride–induced hepatotoxicity. African Journal of Traditional, Complementary and Alternative Medicines 2006; 3(3):1-9.
  21. Pouresmaeil Z, Shoori B, Zargari A. The effect of mouthwash of the leaves of Herbaceous plant in the prevention of oral inflammation caused by chemotherapy. Pazhohandeh Publication 2003; 8(3):9-15.
  22. Fleming VE, Hagen S, Niven C. Does perineal suturing make a difference? The SUNS trial. BJOG: an international journal of obstetrics and gynaecology 2003; 110(7):684-9.
  23. Azhari S, Aradmehr M, Rakhshandeh H, Tara F, Shakeri MT. The effects of chamomile cream on wound healing of episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2014; 17(93):16-26.
  24. Waddell G. Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine 1987; 12(7):632-44.
  25. Taylor C, Laylsyn C. Taylor's nursing fundamentals of nursing concepts. Translator: Eftekharimanesh A, Larijani F. 2th ed. Tehran: Boshri 2010: 230-6.
  26. Shadi M. Comparison of therapeutic effect of Plantago major and Plantago lanceolata ethanolic extracts on wound healing skin of BALB/c mice (Birjand Univesity of Medical Sciences); 2016.‎
  27. Yahya S, Ozgoli G, Mojab F, Alavi Majd H, Shojaee A, Mirhaghjou N. The effect of hypericum perforatum cream on perineal pain after episiotomy in primiparous women. Iran J Obstet Gynecol Infertil 2015; 18(159):1-7.
  28. Nazari S, Ezati Arasteh F, Nazari S, Shobeiri F, Shayan A, Parsa P. Effect of Aloe Vera gel on perineal pain and wound healing after episiotomy among primiparous women: A randomized clinical trial. Iran J Obstet Gynecol Infertil 2019; 21(11):44-51.
  29. Malekizade M, Khadivzadeh T, Rakhshande H, Khajeh Dalouee M. The effect of lavender cream on pain intensity and episiotomy wound healing in nulliparous women. Journal of Mashhad School of Nursing and Midwifery 2009; 20:19.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 9
November 2022
Pages 87-95

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