بررسی تأثیر مصرف واژینال روغن گل پامچال مغربی بر آماده شدن دهانه رحم و سیر زایمان در بارداری ترم: کارآزمایی بالینی تصادفی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 رزیدنت گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی خراسان شمالی، بجنورد، ایران.

4 کارشناس کتابداری، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

10.22038/ijogi.2025.59660.4966

چکیده

مقدمه: آماده‌سازی دهانه رحم، پیش‌نیاز زایمان طبیعی موفق می‌باشد. مطالعات مختلف اثرات متفاوتی از روغن گل پامچال مغربی بر آماده‌سازی دهانه رحم گزارش کرده‌اند که گاه مثبت و گاه بدون تأثیر بوده است. مطالعه حاضر با هدف بررسى تأثیر مصرف روغن گل پامچال مغربی به‌صورت سرپایی بر آمادگی دهانه رحم در حاملگی ترم انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1399 بر روی 76 نفر از مادران باردار با سن حاملگی 40 هفته و مراجعه کننده به بیمارستان‌های آموزشی مشهد انجام شد. افراد در دو گروه 38 نفره مداخله و کنترل قرار گرفتند. برای گروه مداخله پس از تعیین بیشاپ و استریپینگ، یک عدد کپسول گل پامچال واژینال تعبیه شد و هر 6 ساعت دارو برای آنها تکرار گردید. گروه کنترل بعد از معاینه اولیه و تعیین بیشاپ، فقط تحت استریپینگ قرار گرفتند و طی 24 ساعت بعد هر دو گروه فالوآپ شدند. نمره بیشاپ ثانویه، طول فاز نهفته و فعال زایمان، مدت زمان زایمان، نوع زایمان، آپگار دقیقه 1 و 5 و میزان خونریزی بعد از زایمان در دو گروه بررسی گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار SPSS (نسخه 26) و آزمون‌های تی، کای دو و دقیق فیشر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: نمره بیشاپ ثانویه در گروه مداخله (02/1±66/7) به‌طور معنی‌داری بیشتر از گروه کنترل (790/0±39/4) بود (001/0>p). همچنین مدت زمان فاز نهفته در گروه مداخله (85/1±53/7 ساعت) به‌طور معنی‌داری کمتر از گروه کنترل (68/3±28/14 ساعت) بود (001/0>p). فاز فعال زایمانی نیز در گروه مداخله (98/0±69/2 ساعت) به‌طور معنی‌داری کمتر از گروه کنترل (21/1±28/4 ساعت) بود (001/0>p). مدت زمان زایمان بین دو گروه مداخله (8/5±61/18 دقیقه) و کنترل (66/9±78/20 دقیقه) تفاوت آماری معنی‌داری نداشت (243/0=p). این نتایج در میان زنان غیر نخست‌زا نیز مشابه بود. در میان زنان نخست‌زا به‌جز مدت زمان زایمان که به‌طور معنی‌داری در گروه مداخله نسبت به گروه کنترل کاهش یافته بود (به‌ترتیب 71/6±14/22 و 74/4±71/30 دقیقه) (001/0=p)، سایر نتایج مشابه بود.
نتیجه گیری: استفاده از کپسول واژینال گل پامچال مغربی روشی مؤثر، ایمن، مقرون به‌صرفه و بدون نیاز به بستری شدن در بیمارستان برای آماده‌سازی دهانه رحم در زنان باردار می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The Effect of Vaginal Consumption of Evening Primrose Oil on Cervical Preparation and Labor Progress in Term Pregnancy: A Randomized Clinical Trial

نویسندگان [English]

  • Marzieh Lotfalizadeh 1
  • Mahya Labafchi 2
  • Kosar Deldar 3
  • Mansoureh Mohammadnezhad 4
1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Emergency Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran.
4 Librarian, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Cervical preparation is prerequisite for successful natural childbirth. Various studies have reported different effects of evening primrose oil on cervical preparation, which were sometimes positive and sometimes ineffective. The present study was conducted with aim to investigate the effect of taking evening primrose oil as an outpatient basis on cervical preparation in term pregnancy.
Methods: This clinical trial study was conducted in 2020 on 76 pregnant women with gestational age of 40 weeks referred to the teaching hospitals of Mashhad. The subjects were placed in two groups of case and control (n=38 per group). For the intervention group, after determining the bishop and stripping, one vaginal primrose capsule was implanted and the drug was repeated every 6 hours. The control group underwent only stripping after the initial examination and determination of the bishop, and both groups were followed up within 24 hours. Secondary bishop score, latent and active phase of labor, duration of labor, type of labor, 1- and 5-minutes Apgar score and postpartum hemorrhage were assessed in both groups. Data analysis was performed using SPSS software (version 26) and t-test, chi-square, and Fisher's exact tests. P<0.05 was considered significant.
Results: The secondary bishop score in the intervention group was significantly higher than the control group (7.66±1.02 and 4.39±0.790, respectively) (P<0.001), also the duration of the latent phase in the intervention group was significantly lower than the control group (7.53±1.85 and 14.28±3.68 hours, respectively) (P<0.001). The active phase of labor was also significantly lower in the intervention group than the control group (2.69±0.98 and 4.28±1.21 hours, respectively) (P<0.001). There was no statistically significant difference between the intervention and control groups in delivery time (18.61±5.8 and 20.78±9.66 minutes, respectively) (P=0.243). These results were similar among non-primiparous women. Among primiparous women, except for the duration of labor, which was significantly reduced in the intervention group compared to the control group (22.14±6.71 and 30.71±4.74 minutes, respectively) (P=0.001), other results were similar.
Conclusion: The use of evening primrose vaginal capsule is an effective, safe, cost-effective method without the need for hospitalization to prepare the cervix in pregnant women.

کلیدواژه‌ها [English]

  • Active Phase
  • Bishop Score
  • Cervical Preparation
  • Latent Phase
  • Normal Vaginal Delivery
  • Primrose Oil

مراجع

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 7
مهر 1404
صفحه 9-20

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