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Comparing the efficacy of dates and oxytocin in the management of postpartum hemorrhage

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Abstract

Introduction: The aim of study was a comparison between dates and oxytocin in prevention of postpartum haemorrhage. In modern obstetrics, general trend to utilize non-aggressive treatment methods that is quite safe, cheap and few symptoms. Date fruit has Calcium, serotonin, tannin, glucose that they are important for bleeding control. Materials and Methods: This study was performed in Imam Reza and Hazrat Zainab Hospitals, Mashhad University of Medical Science. It was clinical trial that was performed on 62 women delivered in hospital. Immediately after placental delivery, 50 gram oral Deglet Noor dates (group 1) and 10 unit of intramuscular oxytocin (group 2) were given. At the same time a Plastic and a cotton sheet were widen under the patients and a pad was placed on the perineum to absorb blood or fluid. All pads were collected until 3 hour after placental delivery and were weighed every one hour. The difference, before and after weight was calculated.( 100 gram increase in weight was considered to be equivalent to 100 ml blood). Result: Blood loss mean in the end of first hour after delivery were significantly different in dates and oxytocin groups (104 ml vs. 141.6 ml, p=0.043), But in second and third hour were not significant, although the bleeding in dates group was less. In whole three hours after delivery the blood loss mean in dates group was significantly less than oxytocin group (162.5 ml vs. 220.7, p=0.02). Conclusions: Use of oral dates after delivery decreases bleeding more than intramuscular oxytocin and it´s a good alternative in normal delivery. Key Words: postpartum haemorrhage, oxytocin, dates

In the name of God
Department of Internal Medicine
Shiraz E-Medical Journal
Vol. 8, No. 2, April 2007

Comparing the Efficacy of Dates and Oxytocin in the Management of
Postpartum Hemorrhage.
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B<!
+!
 2=5) < (
"   " <  !
  !26(45.
) G! ! #" 
< "  ! ! 
4>>       =7 <
<23485 $ < (
"  <  < 
 <    <
48 +< +" & 
+ +<    :+ :
 235&<  A(
  < ! !  !&
!!   306>    
<!!&+!<
!A!
  "  !& < ! (
& <   ! ! 
!&2@15
!  <
!!!&3>F
8F   +   <  
7>F 205 < < A  
!  !  "
+ & "   
+&  !!  
&  <! + A
 + !  !
 &    ! 
B<!!&  !+(< "
275.#<<!!:"
 A    +  (
3><!!<(
<"!!
!& + +!  20333=5. (
 <  A  (
 < ! ! "
H  &< !<  3>
<  A : !!  !
! < +   "<
!!   + &!
!  "  + 
  285 H  
< " + + (
&  !   (
: "   !! (
 205 9! <!  
!A!<&(
    &" &A 
<  !<  <
<"36    "!
 <!(""&
   B<   
+  "   (
<  $  ! 
$ 9<  "&"  
!!&
 !&   $ 2 
<5&==(=8 $<
    
I +
!& 2375
&   + < 
<!  <  < <
  &!!  +< (
&  !  !  +
:    <   
"  < "
<-
3( . <  ,!< 
 !!    (
!"
! =(. <  < "!<
      < 
65

<  "    ! 
     <!  <<
6( . <  ! < 
"+   !!   
< + & ! !" 
!&!!A&+
<  ! !& 2375.
7()!
"+&<
 +  <  <"
   "  
!&+A(
 +   "!! 
!!&+!

)<+  &(
 !! !  +   +
$ <& !  
  C  8   8=
+!&!
G&4>"."!
 !! 2"< 5 + 3> < (
<<! A 2"< '5  "(
  < "   
("!!&
 (A< ""  ! 
!"     + ."! 
  !" !  ! 
 & +!!
)   <
<+-"+=>(64 
"! 4"!"+
61(7= +: +  !&" < + (
!  !+" (
+=4>>(7>>>""
    &"  (

 << "  &< (
!& (A  !
!" ! <<  (
 ( A  !" 
 !! !  <  
 "  !& 2( A (
!"!&
<   <  ""   A(
!<   5  < (
"  !"  !
+!! !  < <(
   + ! ! 
+ "< 9& < + !!
63 !   < "<  
<  63 !   +
"<   "    " 
! !  ! !&
4> "  ."!   !! +
"&   < "<  3> <
A    + "< 
   ! & + ! 
< !"  ++""
   <" ! !
 3>> "  3>>> "  
&< <!  < !&
9 "  &+"  
+  !& +  B<!
 3 ! ! '! <  <!
+!<"346>748>3=>
31><!&
      ""
+&+  &
&+  !<" ! (
   !   
&< !& + !!  ) (
&"!
     "
 ! + ! ( 
 + ! <"  ( B<
   + ! +
 <    <<! &
!<"2&335
66


) <!     
  "<  A "< +
  !<" " '$ <
!!<
)!!+"+!
 + "<- "  !&
 <   &! +
&<   !&  <<
 < ! + A(
< A(
&! + " A < 
!&!A+""!
     < "" 
<:" !   !"  <:"
)!3+!!&
<<+"<
"<! <<!&
!&"!"   
&(   "(
  A  <! !(
! !&   + 
+  !"  !&  
A "< 2D>>305 2H"
35
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$<!<25
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"< + !   A "<
23>7 ! I 3738 ! D>>765  
   <  !& 
!"    " (
2 < D>>18 
< D>6=05  <    
 "< + !+    
<)&"  ! !"
<" 6 <  !&   +
"< + "  2D>>=5
+!+   "<
A"<238=4!I==>@
!5 H" =  6   !"
      < 
!!6<!&
H"=-,!"&"6<
!&+"<
H"6-HB<<<
!"6<!&+
<"<
&
)     "
 !&  + (
  A  < !"
  " A+
H"=  &"   !"  
 <  ! &"  ! !(
"<"6<!&
!+"<
A"<A
    "  !  (
68

 !"  "!!  (
23>3=345
"!<
    $!  2383@5
<(
  9"& 2315
:<  ! 230085   <"
! A  & 
<  !"  !&205
!2300@5<<
A("!
 !"   !215
) <  <<! "(
A   <   
&+ !<" A ! !" 
 0>>> +2335 ) 
<"+<(
&  A !  &"
< " 2) D 835 
 +    & 
& < "  
+ "!  <  &(
" 2 D 835  2 D
085   + &" "(
A245
 &+!<"3@<(
+(
< <  2 D ==5
"  + &" !
! +  + +
&"  ! <
"    ! +
!<&"2D@5
&" 2 D ==45  2 D
=415!&<2
D 315 !<" "!   (
&   < (
" <   !  : 
<!& !
&  < " 245
! < !   
!" !&
<
. <   
<" "   !& 
 !  . "
<<! !" !&
+!!  < < "
2=>5   + ! (
     !"  
&"
 !"      
<<
 <!<  &!   <!
 2=35 )   <
 ! "  + &!&
3F   +"   ."! 
 2== =65 )     (
!!" !" 2=75
"   A"   +
  !  #! 
2=4=85. !"
     (
=>(,!(
  !!   "- (
"! A  !
2=35 "! !   !
   < <! 
!" ! )A <
!! <<!  &! (
 <  < + (
 &!  A (
 A"     " (
  !" ! 2=35 .  
" ! !:  
!<  < + ! (
< +    + &
      "
!" & ! <(
"! N !& !" A(
&" <  +O ! 
: 235,!<! B< (
 <<!  2=3 =75 )
<<!! 4>! < I
69

>>0"I'3>3"I'=
>==")  3>> " 
 2=65
 !< <&&<<(
<  <  (
&<<(
"    "   
<<A
'(#
) < +  : .  
.$!
)
3(I$:<I)"!
<<<"-
+&?H!G$
=>>8P432=5-41(86
=(H,)!G?B<
Q<"-!
!("!,!9A#(
 !P=>>8-662=5-13(7
6()&(
<"+(
!)? !#=>>=P@8-@4(
@8
7(!.&'
<"-,$NH #
&=>>7(=>>8? !#P
=>>8
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$ !:&"(
<"-"""
!HP=>>8-@6285-3>=4(
1>
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G!!==+Q:$,
+(!!=>>4
@(?!!9!R9&!<A(
<!!&<
("R)$+$
<&!3007
1((RA
"!-!!!
!R'?# !300@P3>72@5-@13(8
0(:<?. !R!(
!!!!"<
<"R !
3008I!2@45-787S81
3>(&!!G9!<.,!)
<A
""!<&(
&+&!!!'?
 !3011P04-6(38
33(&!!G9!<.+ $)
'!"!-R<R&<R(
!"!R""!(
<'$?3011P=0@-3=04S36>>
3=(9!#'$G!<
!!&(
<"'?# !300@P
3>7-668(0
36(!"??$"!(
"<"-
B<!!?!P
=>>8$1@245-466(7>
37(. "
)=>>3
34($,.!&!!G?9!<.
!&A
"!2,&+5)
,!<6#A-<(
+3001
38('<"!.!H<,<$
$!&<(
"? !#=>>3P@6-3(8
3@(<+)G$:H<::
$!&<A"
!!?<!#T =>>3P
@4-=64(73
31(.!R&<
A!&<
"R'?<!
!"&3008I!23>65-
3>81(@6
30(!)(
=>>3
=>(.!$!
@$< 301@
=3(.&G$$IG
+!!.! '
3007
==( !<,
.!<<!"(
<!<%9%&(
%93000
=6(.U:)%&
3006
70

=7(!!$H$,!
!!<!&"+
V"< <!
?<!3008P37265-8=0(
860
=4(<!.W$U&+(
<"X+Q:':
3008-6@>(@6
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Copyright © 2007 by Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. All rights reserved.
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... Furthermore, these fatty acids are claimed to be involved in prostaglandins production pathways. As a result, dates can positively improve the energy levels and the muscles' strength of the uterus (13,20,26). ...
... Therefore, the administration of approved natural products needs to be performed cautiously and the high levels of accuracy should be considered regarding the appropriate timing of prescription and elimination of high-risk patients. (13,20,26), the acquired results were not the same, which can be attributed to different methods adopted in these studies. In the study performed by Mojahed et al., the intervention group received the medication immediately after placental withdrawal, including the infusion of 20 units of oxytocin in 1,000 ccs of saline with 100 g of Phoenix dactylifera with a glass of warm water, while the controls were administrated with the infusion of 20 units of oxytocin in 1,000 ccs of saline. ...
... The bleeding rate was assessed up to 3 h of postpartum . The results showed that the administration of Phoenix dactylifera was a more effective approach toward reducing the postpartum hemorrhage, in comparison with an intramuscular injection of oxytocin (26). In the study of Yadegari et al., the intervention group was prescribed 100 g Phoenix dactylifera within the first two hours of the post-delivery phase. ...
... Studies have shown that date fruit, a reinforcing fruit rich in carbohydrates, affects the progress and spontaneity of labor and reduces postpartum hemorrhage (10)(11)(12). Date is a reinforcing fruit rich in carbohydrates; these carbohydrates are simple sugars, absorbed and used by the cells shortly after consumption. Date fruit also contains vitamin B, iron minerals, calcium, magnesium, and potassium. ...
... It seems that date fruit influences oxytocin receptors, stimulates the uterine muscles to respond more comfortably to oxytocins, and better prepares the uterus and cervix for delivery (10). Khadem et al. (2007) demonstrated that date fruit has oxytocin-like effects and its nutritional and therapeutic characterristics reduce postpartum hemorrhage; it can also be a suitable alternative for oxytocin (12). ...
... It seems that date fruit influences oxytocin receptors, stimulates the uterine muscles to respond more comfortably to oxytocins, and better prepares the uterus and cervix for delivery (10). Khadem et al. (2007) demonstrated that date fruit has oxytocin-like effects and its nutritional and therapeutic characterristics reduce postpartum hemorrhage; it can also be a suitable alternative for oxytocin (12). ...
... In addition, serotonin contained in date fruit can contribute to smooth muscle contractions. 22 At 2007 Khadem et al. have executed a prospective clinical trial to examine the efficacy of date fruit in prevention of postpartum hemorrhage. 22 Immediately following the delivery of the placenta, parturients in the intervention group consumed 50 gram of date fruit, while the control cohort were treated by intramuscular oxytocin (n=31 in each group). ...
... 22 At 2007 Khadem et al. have executed a prospective clinical trial to examine the efficacy of date fruit in prevention of postpartum hemorrhage. 22 Immediately following the delivery of the placenta, parturients in the intervention group consumed 50 gram of date fruit, while the control cohort were treated by intramuscular oxytocin (n=31 in each group). Weighting of perineal pads and sheets was performed hourly for 3 hours after the delivery. ...
... The abovementioned study of Khadem et al. describing the utility of date fruit in prevention of postpartum hemorrhage used Deglet Noor dates. 22 Thus, future trials examining this issue should strive to evaluate the possible differences in various sorts of dates. ...
Article
Objective To summarize the available evidence exploring the influence of date fruit consumption on delivery outcomes. Methods A search was conducted for relevant articles in three databases for manuscripts in English, with no time restrictions. Results Four articles were eligible for inclusion. Women consuming date fruit were admitted with higher cervical dilatation (mean difference (MD) 1.1 cm [95% confidence interval (CI) 0.2-1.99 cm) and yielded a lower need for labor induction/augmentation (relative risk (RR) 0.6, 95% CI 0.43-0.83). Date fruit consumption was associated with shorter latent phase (MD -4.6 hours, 95% CI -7.77 to -1.4) and second stage duration (MD -7.7 minutes, 95% CI -12.0 to -3.4). Conclusions Although the overall quality of the included studies was weak due to high risk of bias, the results of our meta-analysis point to beneficial effects of date fruit consumption on labor process. fruit
... 7 One research study examined a case of consuming 50 g of date fruits in late pregnancy, and revealed that date fruit consumption gave similar benefits as Oxytocin injection, which helps reduce postpartum hemorrhage and involution. 8 Another study showed that the consumption of six date fruits/day during late pregnancy reduced labor duration, increased cervical dilatation, and the rate of natural childbirth. 9 The authors found only one research article on the subject of date fruit consumption and breast milk quantity and infant weight. ...
Article
Full-text available
Background: Date fruit is a popular natural galactagogue among breastfeeding Muslim mothers. However, there is no evidence to support the effectiveness of date fruit in increasing the quantity of breast milk. Objective: This research aimed to study the effect of date fruit consumption on breast milk quantity and nutritional status of infants. Materials and Methods: This was a parallel randomized controlled trial. Forty-eight pairs of breastfeeding mothers and infants aged 1-3 months were included. The intervention group (n = 25) was asked to consume their normal dietary intake with 10 date fruits/day for 4 weeks. The control group (n = 23) was asked to consume their normal dietary intake without date fruit. Breast milk quantity was measured by using an electric breast pump and recorded for 2 days at baseline, week 2 and 4. The nutritional status of infants was assessed by calculating infant weight-for-age at baseline and week 4. Dietary data were collected at baseline, week 2, and 4, using a 2-day food record. Data were analyzed using Chi-square, t-test Mann-Whitney U test, and Wilcoxon matched-pairs signed-ranks test by SPSS version 18.0. Results: Breastfeeding mothers who received 10 date fruits/day had an 11% increase in breast milk quantity from baseline to week 2, and a 23% increase from baseline to week 4, (both p < 0.05). The breast milk quantity of the breastfeeding mothers who received date fruits was significantly higher than that of the control group (p < 0.05). However, there were no differences in infant nutritional status. Conclusions: Date fruit consumption appears to be useful for promoting and increasing breast milk quantity in breastfeeding mothers. Date fruits may be an alternative galactagogue.
... Khadem et al. [58] conducted a study to check the effect of date fruit on a postpartum hemorrhage. Results manifested that the mean of blood loss in the date group was significantly less than the oxytocin group in the entire three hours after delivery. ...
Article
Full-text available
Male and female infertility is a global major health problem. Approximately 15% of couples of reproductive ages are unable to achieve the desired pregnancy within 12 months, despite daily unprotected sexual intercourse and about 10% of infertilities have no specific reason world-wide. Currently, many researchers are interested to investigate the use of natural remedies for preventive and curative purposes of infertility. This review brings together some of the data on the nutritional characteristics of the date palm and its different parts on fertility outcomes and critically evaluates the past and recent literature relevant to the consumption of date fruit against infertility-related problems. Due to its antioxidant potential, dates are considered a functional treatment for reducing the risks of infertility. In males, the date palm has a potent effect on the reproductive parameters including hormonal levels and seminal vesicle parameters as well as sperm motility, count, and viability; whereas, in females, it shows a convincing effect on reproductive parameters including oogenesis process, strengthening of oocytes, regulation of hormones, strengthening of pregnancy, reduction of the need for labor augmentation and postpartum hemorrhage prevention.
... 56 Three studies introduced these mechanisms of date palm effect on postpartum hemorrhage. 36,40,44 Furthermore, prostaglandins are common drugs used for labor induction. 57 Razali et al 29 bleeding. ...
Article
Purpose The aim of present study was to review and categorize the clinical trials investigating the clinical effects of different botanical parts of dates compared with any controls. Methods All clinical trials (randomized, pilot, quasi-experimental, cross-over. and non-randomized clinical trials) evaluating the clinical effects of date palm from 2000 until August 2019 in English and Persian languages were included in this systematic review. The methodological quality of the included studies was evaluated according to the risk of bias assessment of Cochrane handbook of systematic reviews, and then reported using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results Twenty-six studies met the inclusion criteria. Studies were performed in 8 categories based on different botanical parts of date palm. These categories were obstetrics, gynecology, oncology, dermatology, hematology, gastroenterology, endocrinology, metabolism, and infertility. A total of 38 % of included studies were randomized controlled trials. Further, 80 % of the included studies had performance and detection bias. Finally, about 50 % of them had selection bias and about 20 % had attrition and reporting bias. Conclusion The widespread consumption of date palm as medicinal and botanical plant suggests the importance of this plant in human healthcare. The clinical trials conducted so far have explained a number of clinical effects of date palm. However, there is not enough clinical evidence to support the clinical effects in other review articles and traditional medical systems, and further randomized controlled trials with robust designs and methods are required.
Article
Full-text available
Introduction: Preparation of the cervix and induction of labor is necessary before the onset of labor. In traditional medicine, rose has been used as an effective factor in the onset of labor contractions. However, clinical studies on its efficacy are very rare. This study was done to determine the effect of oral rose-water on cervical ripening in primiparous women. Methods: This study was a randomized clinical trial on 60 primiparous women with 40 weeks of gestation who were assigned to two groups of 30 people of intervention and control using method of intervention blocks. Intervention group consumed five ml of Rose water daily orally since 40 week of gestation for one week and the control group, was received routine care. One, three and seven days after beginning of the intervention and entering the labour, Bishop's score was measured. Data were gathered by a questionnaire form, physical examination, observing and counting fetal movement and check list of rose-water consumption. Data were analyzed using T-tests, analysis of variance and repeated values. Results: The mean age of patients in the intervention and control group was 26.53± 5.16, 26.53± 5.28 respectively. The onset of labor did not show a significant difference in two groups(p=0.303). Analysis of variance in duplicate measurements showed that the mean of Bishop's grade point average on the third and seventh days after beginning of intervention in the two groups did not differ significantly from each other (p =0/160). Also, the results of this test showed that the trend of bishop score changes in both groups was incremental. Conclusion: Consumption of 5 ml of rose-water daily, no significant effect on preparing cervix and was safe. It is recommended for future research to assess the effect of higher dose of rose-water on preparing cervix. and induce labor, compare it with the control group, for future research. Keywords: Delivery, Cervical ripening, Rosewater, Term pregnancy
Chapter
In arid and semiarid areas, date palm is an essential fruit crop. Date is considered an ideal food with numerous nutritional and medicinal properties. Date is rich in sugar, protein, dietary fiber, minerals, and some vitamins. Its pulp, pit, pollen, and spathe extracts were used to prevent a wide range of chronic diseases. It contains a broad range of secondary metabolites, including anthocyanins, carotenoids, flavonoids, phenolic acid, procyanidins, and sterols. Date bioactive compounds are antioxidants, antimicrobial, anticancer, anti-inflammatory, and hepatoprotective. Biosynthesis of these compounds is influenced by several factors such as sunlight, irrigation, cultivar, tissue type, pollination, thinning, and maturity stage. This chapter discusses the medicinal and nutritional value of dates with an emphasis on secondary metabolites and various factors influencing their biosynthesis, pharmaceutical benefits, and potential use in functional food. Recent advances in metabolomics are also discussed.
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