The effect of acupressure on uterine tone and pain after delivery

Document Type : Original Article

Authors

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

2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran.

3 Assistant Professor, Department of Traditional Chinese medicine and Complementary Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Science, Mashhad, Iran.

4 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

5 Instructor, Department of Surgery Internal Nursing, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran.

Abstract

Introduction: Uterine Atony is the most common cause of postpartum bleeding and uterus contraction is associated with pain. Acupressure stimulates physiological functions of channels and in certain disease by management of symptoms and increasing the flow of energy causes balance in the inner function of the body. This study was performed with aim to assess the effect of acupressure on uterine tone and pain after delivery
Methods: This randomized double-blind clinical trial was performed in 2015 on 114 mothers with NVD in Omolbanin hospital. The subjects were randomly allocated into three groups of main acupressure, sham (placebo point), and control. In the main acupressure group, after newborn delivery and before placenta expulsion, 2 minutes pressure was applied on points CV6 and 4, and in sham acupressure group, less pressure was applied on 2 placebo points. There was no intervention in control group. The Research Assistant measured uterine tone using VAS immediately after placenta expulsion and during afterpain, at 1 and 2 hours after birth. Data were analyzed by SPSS software (version 16) and Kruskal-Wallis, Variance analysis, and Chi-square tests. P<0.05 was considered significant.
Results: Contracted uterine tone in the main acupressure group, right after placenta expulsion and at 1 and 2 hours post-delivery was %89.5, %86.8 and %86.8, respectively, and in sham acupressure group was %86.8, %84.2 and %89.5, respectively, and in control group was %81.6, %76.3 and %78.8, respectively. Despite it was more in the main group than the control group, but Kruskal-Wallis Test showed no significant difference in the three groups (P>0.05). Mean score of pain severity at 1 and 2 hours post-delivery in the main acupressure group was 8.9±17.5 and 4.6±11.9, respectively, and in sham acupressure group was 2.5±15.9 and 5.3±13.9, respectively, and in control group was 9.8±19.2 and 7.6±17.4. Despite that it was less in the main group than in the control group, Kruskal-Wallis Test showed no significant difference in the three groups (P>0.05).
Conclusion: Acupressure on main points has no effect on the uterine tone and pain at 1 and 2 hours post-delivery, but performing further studies are necessary to determine its effect on the tone and pain during the period under consideration.

Keywords


  1. Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obestetrics. 24th ed. New York: Mcgraw-Hill; 2014.
  2. Mogibian M, Salehi E, Enjezab B, Tabatabaie AS. Comparing the effectiveness of two methods of oxytocin infusion in preventing atonic uterus. J Reprod Infertil 2005; 6(3):240-6. (Persian).
  3. Gabbe SG, Niebyl J, Simpson JL, Landon M, Galan HL, Jauniaux ER, et al. Obstetrics: normal and problem pregnancies e-book. New York: Elsevier Health Sciences; 2012.
  4. Varney H, Kriebs JM, Gegor CL. Varney's midwifery. Massachusetts: Jones & Bartlett Learning; 2004.
  5. 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.
  6. West Z. Acupuncture in pregnancy and childbirth. 2nd ed. New York: Elsevier Health Sciences; 2008.
  7. Shadipour M, Simbar M, Salamzadeh J, Nasire N. A comparative study on the effects of Menstrogol and Mefenamic acid on postpartum after-pain. Iran South Med J 2014; 16(6):401-9. (Persian).
  8. Vahidi AA, Eranmanesh E. Breastfeeding and medications. J Kerman Univ Med Sci 2011; 18(2):194-206. (Persian).
  9. Mahdavian M, Golmakani M, Mansouri A, Hoseinzadeh H, Afzalaghaee M. An investigation of effectiveness of oral drill extracts on post partum hemorrhage. J Women Midwifery Infertil Iran 2001; 78(4):19-26. (Persian).
  10. Mirghafourvand M, Mohamad Alizadeh Chrandabi S, Abasalizadeh F, Shirdel M. The effect of intravenous tranexamic acid on hemoglobin and hematocrit levels after vaginal delivery: a randomized controlled trial. Iran J Obstet Gynecol Infertil 2013; 16(60):1-8. (Persian)
  11. Rakhshekhorshid M, Foadoddini M, Saadatjoo SA. Comparison between the effects of applying massage andice massage to SP6 (SPLEEN6) point on severity and length of primary dysmenorrhea. J Birjand Univ Med Sci 2013; 20(1):11-9. (Persian).
  12. Simoncini M, Gatti A, Quirico PE, Balla S, Capellero B, Obialero R, et al. Acupressure in insomnia and other sleep disorders in elderly institutionalized patients suffering from Alzheimer’s disease. Aging Clin Exp Res 2015; 27(1):37-42.
  13. Navidi A, Ghasemi Soleymaniesh MA. Encyclopedia of holistic medicine traditional and modern methods in medicine. Tehran: Tabib; 2003.
  14. López‐Garrido B, García‐Gonzalo J, Patrón‐Rodriguez C, Marlasca‐Gutiérrez MJ, Gil‐Pita R, Toro‐Flores R. Influence of acupuncture on the third stage of labor: a randomized controlled trial. J Midwifery Womens Health 2015; 60(2):199-205.
  15. Acupuncture needle-boen healthcare. Acupuncture Channels. Available at: URL: http://www.sacredlotus.com/go/acupuncture/point; 2017.
  16. Focks C. E-book-atlas of acupuncture. New York: Elsevier Health Sciences; 2008.
  17. Yu S, Yang J, Yang M, Gao Y, Chen J, Ren Y, et al. Application of acupoints and meridians for the treatment of primary dysmenorrhea: a data mining-based literature study. Evid Based Complement Alternat Med 2015; 2015:752194.
  18. Bazarganipour F, Lamyian M, Heshmat R, Abadi MA, Taghavi A. A randomized clinical trial of the efficacy of applying a simple acupressure protocol to the Taichong point in relieving dysmenorrhea. Int J Gynecol Obstet 2010; 111(2):105-9.
  19. Wu ZX, He GH, Wang Q. Uterine involution after cesarean section promoted with acupuncture: a randomized controlled trial. Zhongguo Zhen Jiu 2014; 34(9):873-6.
  20. Jiang Y, Cui J. Impacts on the duration of vaginal bleeding and the levels of serum estradiol (E2) and progesterone (P) for patients of midtrimester induction of labor treated with moxibustion at Guanyuan (CV4) and Shenque (CV8). Zhongguo Zhen Jiu 2011; 31(9):769-72.
  21. Gaudernack LC, Forbord S, Hole E. Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial. Acta Obstet Gynecol Scand 2006; 85(11):1348-53.
  22. Gharloghi S, Torkzahrani S, Akbarzadeh AR, Heshmat R. The effects of acupressure on severity of primary dysmenorrhea. Patient Prefer Adherence 2012; 6:137-42.
  23. 23.Chen MN, Chien LW, Liu CF. Acupuncture or acupressure at the sanyinjiao (SP6) acupoint for the treatment of primary dysmenorrhea: a meta-analysis. Evid Based Complement Alternat Med 2013; 2013:493038.
  24. Golbabaei SH, Ghanbar M, Hematpour K. Therapeutic effects of acupuncture on patients with migraine: a before-after study. Tehran Univ Med J 2008; 66(7):475-9. (Persian).
  25. Babajani S, Babatabar H, Ebadi A, Mahmoudi H, Nasiri E. The effect of foot reflexology massage on the level of pain during chest tube removal after open heart surgery. J Crit Care Nurs 2014; 7(1):15-22.
  26. Seca S, Miranda D, Cardoso D, Greten H, Cabrita A, Rodrigues MA. The effectiveness of acupuncture on pain, physical function and health-related quality of life in patients with rheumatoid arthritis: a systematic review protocol. JBI Database System Rev Implementat Rep 2016; 14(5):18-26.