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Investigating the Effect of Primrose Capsule (Primula Flower Oil) on Cervix Preparation and Commencement of Child Delivery Pains

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Investigating the Effect of Primrose Capsule (Primula Flower Oil) on Cervix Preparation and Commencement of Child Delivery Pains Investigating the effect of Primrose Capsule (Primula Flower Oil) on cervix preparation and commencement of child delivery pains Investigación del efecto de Primrose Capsule (Primula Flower Oil) en la preparación del cérvix y el comienzo de los dolores de parto infantil 118 Maryam Hashemnejad1, Mina Ataei2*, Mahdieh Modarresi3, Fatemeh Forutan4 1Assistant Professor of Obstetrics and Gynecology, School of medical sciences, Alborz University of Medical Sciences, Karaj, Iran. 2Assistant Professor of Obstetrics and Gynecology, Non-communicable Diseases research center, Alborz University of Medical Sciences, Karaj, Iran. 3Gynaecologist, Alborz University of Medical Sciences, Alborz, Iran. 4Student Research Committee, Alborz University of Medical Science, Karaj, Iran. *Corresponding Author: Mina Ataei, Assistant Professor of Obstetrics and Gynecology, Non-communicable Diseases research center, Alborz University of Medical Sciences, Karaj, Iran, Tell: 009126671381. EMAIL: [email protected] Introduction: Oenothera biennis (primrose) oil is one and labor duration and delivery time. In the end, the col- of the most common herbal medicines used for prepar- lected information was analyzed using SPSS. ing cervix but its effectiveness is yet to be proved. There Result: based on the analyses, the two groups were not are limited articles on the effectiveness of this medicine found significantly different in terms of the demographic Abstract in inducing delivery. The present study was designed and data. Moreover, no significant difference was observed in conducted with the objective of investigating the effec- terms of the interval between the primrose administration tiveness of vaginal administering of evening primrose in and delivery pain initiation (T1) and the interval between inducing delivery. primrose use till delivery (T2) as compared to the control Study Method: the present study is a triple blind case- group (P>0.05). evidence clinical trial. Out of the individuals featuring the Discussion: it seems that the vaginal application of prim- required qualifications for entering the study, 160 were rose capsule is not effective in cervix preparation. How- randomly selected and assigned into two equal groups. ever, there is a need for further research in this area. The Following the acquisition of the consent letter, the par- current studies on the effectiveness of the evening prim- ticipants were subjected to clinical examinations. Their rose is limited to two researchers that have also found preliminary information was recorded. Then, two soft results consistent with what has been found here and two primrose capsules were placed in the posterior choledo- other studies with results not in accordance with the cur- sac of the intervention group participants. Placebo cap- rent paper’s findings. More comparative studies seem to sules were used in control group. Next, the patients were be useful in this regard. asked to leave a contact number for the future required Keywords: cervix preparation, primrose (primula), deliv- follow-ups in terms of the delivery pain commencement ery induction. Introducción: El aceite de Oenothera biennis (onagra) es cos. Su información preliminar fue registrada. Luego, se una de las hierbas medicinales más comunes que se uti- colocaron dos cápsulas de prímula suave en el coledosac lizan para preparar el cuello uterino, pero su efectividad posterior de los participantes del grupo de intervención. aún no se ha demostrado. Hay artículos limitados sobre la Se utilizaron cápsulas de placebo en el grupo control. A Resumen efectividad de este medicamento para inducir el parto. El continuación, se les pidió a los pacientes que dejaran un presente estudio fue diseñado y realizado con el objetivo número de contacto para las futuras actividades de se- de investigar la efectividad de la administración vaginal de guimiento requeridas en cuanto al comienzo del parto, la onagra para inducir el parto. duración del parto y el tiempo de parto. Al final, la infor- mación recolectada fue analizada utilizando SPSS. Método de estudio: el presente estudio es un ensayo clí- nico de prueba de casos triple ciego. De los individuos con Resultado: según los análisis, los dos grupos no se en- las calificaciones requeridas para ingresar al estudio, 160 contraron significativamente diferentes en cuanto a los fueron seleccionados al azar y asignados en dos grupos datos demográficos. Además, no se observó una diferen- iguales. Tras la adquisición de la carta de consentimien- cia significativa en términos del intervalo entre la adminis- to, los participantes fueron sometidos a exámenes clíni- tración de onagra y el inicio del dolor en el parto (T1) y el www.revhipertension.com Revista Latinoamericana de Hipertensión. Vol. 14 - Nº 1, 2019 intervalo entre el uso de la primavera hasta el parto (T2) and it has been stated that it might ease the delivery pro- en comparación con el grupo de control (P> 0,05). cess for the mothers. Discusión: parece que la aplicación vaginal de la cápsu- Evening primrose is a biennial and wild plant with yellow la de onagra no es efectiva en la preparación del cuello flowers that grows in the north and south of the US and uterino. Sin embargo, hay una necesidad de investigación Europe. The plant is used for treating systemic diseases adicional en esta área. Los estudios actuales sobre la efec- caused by inflammation (like atopic dermatitis and rheu- tividad de la onagra se limitan a dos investigadores que matoid arthritis, breast pain, menopausal symptoms and también encontraron resultados consistentes con lo que pre-menopausal signs7. The oil of this plant is one of the se ha encontrado aquí y otros dos estudios con resultados most common herbal medicines used for cervix prepara- que no están de acuerdo con los hallazgos del presente tion but its effectiveness is yet to be proved8. Primrose documento. Más estudios comparativos parecen ser útiles capsule contains the oil of evening primrose9. And it is en este sentido. made from the seeds of this plant and linoleic acid ac- counts for the greatest quotient of its ingredients (60- Palabras clave: Preparación del cuello uterino, prímula, 65%). 119 inducción del parto. In the end, according to the studies performed up to now, there is a scarcity of research about the effectiveness of evening primrose oil in delivery induction and, addition- ally, its vaginal use has not been so far examined. Besides reducing the systemic effects, the vaginal out-patient ad- ministering of this drug can induce delivery as a noninva- elivery induction is one of the common sive, cheap and available method with few side effects. Introduction clinical cases with a prevalence rate be- According to the aforementioned materials, the present tween 10% and 30%. Cervix readiness study deals with the investigation of vaginal administering is one of the important conditions before delivery induc- of this product in cervix preparation in pregnancy termi- tion in such a way that it is estimated that normal delivery nation candidates in their week 37 of gestation. does not occur in the absence of ready cervix 1. The most common method for cervix preparation is Bishop’s scor- ing system (Bishop Score). The time to vaginal delivery is in an inverse relationship with Bishop’s score. This scor- ing system includes five items, namely dilation, efface- ment, fetus head’s position, cervix’s consistency and state. Scores above six indicate the vaginal delivery likelihood he present study was carried out on pregnant and scores below six are reflective of the reduction in the women in their week 37 of gestation (based natural delivery success1. on LMP or sonography of the first trimester of Materials and methods pregnancy). These women were pregnancy termination Various methods have been suggested for cervix prepa- candidates and had referred to the emergency unit of ration. Amongst the nonmedicinal methods, the sexual Karaj’s Kamali educational-treatment center during 2019. intercourse, stimulation of nipples, nervous stimulation Sampling was conducted based on convenience method. of the skin, hot water bath, enema, acupuncture, herbal The study sample volume was computed based on the medicines, castor oil, mechanical methods and surgery can (formula 1) for comparing two means F: be pointed out. There are different drugs for preparing cer- vix. Amongst the available drugs, as well, prostaglandins, including misoprostol, can be pointed out1. The use of nat- (1) ural processes during pregnancy is one of the notable is- 3 sues should be researched further .The prevalence of using With α=0.05 (type I error), β=0.2 (type II error, variance=9 plant byproducts in pregnancy has been estimated up to and d=4 based on a review of the related texts. According 55% and this amount depends on the geographical region to this, 80 pregnant women were randomly selected as and ethnic cultures4. Based on the estimations in the US, the case group (group A) and 80 women were randomly between 45% and 95% of the obstetricians recommend selected as control group (group B) by picking previously plant-based and natural products during pregnancy. In be- coded packets and allowed to enter the study after offer- tween, evening primrose, castor oil, black cohosh and blue ing a written consent. cohosh are more frequently prescribed5. The study inclusion criteria were as follows: the generally Evening primrose is one of the most common herbal med- good status of the mother, absence of any hospitaliza- icines prescribed for cervix preparation but its effective- tion indicator except pregnancy termination, Bishop Score ness has not yet been proved. It seems that the use of eve- below 4 during examination, no need for emergency de- ning primrose during pregnancy has not been prohibited. livery, mother’s ability of quick presence in the treatment In some studies, this oil has been used as a supplement6, center and the individuals with the foresaid conditions who did not want to participate in the study for any rea- there was found no significant difference between T1 in son were put aside.
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