effect of aloe vera ointment on the intensity of perineal pain following episiotomy: a randomized blind clinical trial

Background and Purpose: Aloe vera has long been used as a medication of many diseases but the research approving its analgesic effects are not many. Since the effect of its ointment on episiotomy pain has been investigated, we intended to determine the effect of aloe vera ointment on the pain intensity of episiotomy among primiparous women

Methods and Materials: This blind randomized clinical trial was conducted on 74 primiparous women, having the inclusion criteria, admitted to Lolagar hospital in Tehran, Iran; the participants were continuously assigned into two groups by random allocation: experimental [using the aloe vera ointment] and control [routine medication]. The experimental group [37 women] consumed Aloe vera ointment 3cc / 60 mg every 8 hours; and the control group [37 women] consumed the hospital routine care [Povidone Iodine] for five days. Data collection instruments were a demographic questionnaire and VAS scale, for recording the pain intensity before application, 4 and 8 hours and 5 days after application in both groups. The obtained data were analyzed in SPSS 16 using independent t-test and chisquare

Results: Mean pain score of the experimental and control groups before application of aloe vera ointment were 6.24 +/- 1.57 and 6.02 +/- 1.77 respectively, which reduced to 1.86 +/- 1.45 and 3.97 +/- 2.19 respectively five days after intervention; the difference between the two groups was significant [p<0.01]; however, the pain score four hours after application was not significant

Conclusion: Aloe vera ointment can be used in episiotomy wound care to reduce the pain intensity and the need for pain killers

effect of lavender essence on the post-episiotomy pain intensity of perineum

Background and Purpose: Post-episiotomy pain affects maternal life quality and mental health as well as her care and relationship with the infant. Currently the use of complementary medicine has become common; for instance the use of lavender essence is specifically prevalent in medicine and midwifery but findings about this essence are few and contradictory. Therefore the present research was conducted to investigate the effect of lavender essence on post-episiotomy pain in primipara

Methods and Materials: This single-blind clinical trial involved 60 qualified primiparous women admitted for labor in Kamali Hospital in Karaj Iran. They were randomly allocated into two groups: cases [bathing in lavender essence] and controls [receiving the hospital routine]. For five days after labor case mothers were given essential oil of lavender [twice a day each time 6 drops in 5 liters of water] and control mothers were given the hospital; routine [Betadine] for bathing in. The study data were collected through demographic data questionnaire analgesic checklist and visual analog scale of pain. The participants' pain was recorded on the VAS scale 4 hours 12 hours ad 5 days after episiotomy. The obtained data were analyzed in SPSS 14 using independent t-test and chi-square

Results: The two groups did not show any significant differences as for their demographic data and variables of the study. Mean pain intensity in the lavender and Betadine groups were 2.7?1.7 and 4.23?1.59 respectively which shifted to 2.43?1.94 and 4.60?1.79 respectively five days after surgery; the difference came out to be significant

effect of hands-off and hands-on methods on perineal status

Background and Purpose: Perineal damage is one of the traumas most frequently suffered by women during delivery. There are several techniques aimed at reducing the perineal damage. The present study is aimed at determining and comparing the frequency and degree of perineal rupture in hands-off and hands-on techniques of protecting perinea during labor

Method and Materials: This blind clinical trial [with the CI of 95% and test power of 80%] involved 187 women who, after signing their informed consent, were divided into the hands-off [n= 98] and hands-on [n=89] groups through random allocation. In the experimental [hands-off] method, the midwife guides the parturient and observes the process of labor without touching the perineum or the head. In the control [hands-on] group, the midwife protects the infant's head using Ringen maneuver. The data were analyzed in SPSS using chi-square and Fisher's exact test

Results: The result showed that the undamaged perinea in the hands-off group was 44.9%, versus 10% in the hands-on group, where the difference was statistically significant [P < 0.0001]. Perineal laceration was 51% in the hands-off group and 47.2% in the hands-on group but the difference between the two groups was not significant [p = 0.55]. Most ruptures were of the firstdegree type [50% in the hands-off and 64.3% in the hands-on group]. In the hands-off group, 3.1% underwent episiotomy as compared with 75.3% in the hands-on group

Conclusion: The results suggest that a policy of hands-off technique in protecting perinea can be safe and efficient technique and can be an alternative method in perineal protection during labor

[Breastfeeding self efficacy and perceived stress in primiparous mothers]

Breastfeeding is a health-promoting and disease-preventing activity of mother with acceptable cost-effectiveness. Successful breastfeeding depends on various physiological and psychological factors such as maternal breastfeeding self efficacy and perceived stress. The aim of this study is to determine exclusive breastfeeding self efficacy and perceived stress in primipara mothers. The data collection instrument was a questionnaire consisted of the demographic characteristics items, and breastfeeding self efficacy and perceived stress scales. Three hundred and thirty one primiparous women, referred to Shahid Akbarabadi Hospital in Tehran, were selected continuously [within three months] to complete the questionnaire. The results of this study showed that less than half of the subjects [46.5%] had high perceived stress level. In addition, more than 51.1% of mothers had high breastfeeding self efficacy. Therefore, according to the study findings and recent reports regarding reduced rate of breast feeding in Iran, it is necessary for health care responsible to provide appropriate strategies in order to increase breastfeeding self efficacy and stress management, especially in less experienced primipara women. Accoding to findings and with due attention to recent decrease in breast-feeding in Iran, it is necessary to develop proper strategies in order to improving breast feeding self efficacy and effective stress management, especially in primiparous mothers

[Effects of complementary therapies on pain and labor outcomes in nuliparous women referred to delivery unit in Fatemiyeh Hospital in Shahrood city [2003-2005]]

Labor pain is the most severe pain in the world and its control is the main goal of maternity care. Nowadays, complementary therapies are suggested in order to labor pain elimination and there is controversial idea about applying of these methods. This study assessed the effects of emotional support and non pharmacological pain relief in labor. In this experimental study, 300 nuliparous women [150 women in control and 150 in empirical group] with single pregnancy, cephalic presentation and spontaneous labor who referred to the Fatemiyeh hospital, Shahrood, Iran, were evaluated. 150 women of empirical group received non pharmacological pain relief methods, including massage therapy, breathing techniques, relaxation, effleurage and emotional supports. No one of them received pharmacological pain relief methods. Pain intensity in the first and second stage of labor was determined by verbal numeric analog scale. Data were analyzed by Mann-Whitney U, Chi- square and Fisher exact tests. There was no difference in mean of age, level of education, residency [rural or urban], vaginal exam in admission time and interventions in labor between two groups. In control group, cesarean request [26.6% vs 16.2%, p < 0.05], ventous applying [4.5% vs 0%, p < 0.01], duration of the first [p < 0.001] and second stage of labor [p < 0.05 [and mean of pain score in the first [p < 0.01] and second stage] p < 0.001 [of labor was greater and mean apgar score in 1 min [p < 0.01] was less than experimental group. This study showed positive effects of complementary therapies on pain relief and labor outcomes. So, education of pregnant women, progress in willingness for vaginal delivery and presenting the complementary therapies are recommended in labor units