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The effect of late pregnancy consumption of date fruit on labour and delivery
Journal of Obstetrics and Gynaecology
Abstract
We set out to investigate the effect of date fruit (Phoenix dactylifera) consumption on labour parameters and delivery outcomes. Between 1 February 2007 and 31 January 2008 at Jordan University of Science and Technology, a prospective study was carried out on 69 women who consumed six date fruits per day for 4 weeks prior to their estimated date of delivery, compared with 45 women who consumed none. There was no significant difference in gestational age, age and parity between the two groups. The women who consumed date fruit had significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers (3.52 cm vs 2.02 cm, p < 0.0005), and a significantly higher proportion of intact membranes (83% vs 60%, p = 0.007). Spontaneous labour occurred in 96% of those who consumed dates, compared with 79% women in the non-date fruit consumers (p = 0.024). Use of prostin/oxytocin was significantly lower in women who consumed dates (28%), compared with the non-date fruit consumers (47%) (p = 0.036). The mean latent phase of the first stage of labour was shorter in women who consumed date fruit compared with the non-date fruit consumers (510 min vs 906 min, p = 0.044). It is concluded that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomised controlled trial.
... Additionally, those who consumed dates experienced a lower incidence of using oxytocin to induce labor (28%), compared with those who did not consume dates (47%), and the latency period was shorter. 10,11 Dates greatly influence the progression or acceleration of the first stage of labor, such as dates juice, dried dates, fresh dates, young dates extract, or a combination. Pregnant women are recommended to start consuming dates in the last four weeks of pregnancy, or at 37 weeks of gestation.8 ...
... Consuming six dates daily during the final stages of pregnancy can shorten labor time, speeds up cervical dilation, and increase the rate of natural delivery. 11 Consuming dates causes labor to advance more quickly, , shortens the duration of the active phase due to the force of uterine contractions, which has an impact on cervical dilation, improves the BISHOP score, and decrease the number of cesarean sections. 10,12,13 In the first stage of the latent phase, the majority of mothers want to eat and this percentage drops after entering the active phase, as it manifests more frequently. ...
... -22.29), p=0.01). 11 Besides, consuming dates can dramatically shorten the active phase's duration and boost the Bishop's score, which lowers the need for cesarean section in the intervention group compared to the control group. 13 In this study, the intervention given was a dates milkshake made from Sukari dates, formula milk, honey, and lemon juice. ...
Background: Prolonged labor can occur due to malnutrition during the first stage of labor. During the labor process, women need foods rich in sugar, such as dates milkshake, to optimize uterine contractions. This study aimed to explore the effect of dates milkshake on the duration of the first stage of labor.Method: This study was a quasi-experiment conducted from August to November 2021 in Bengkulu City, Indonesia using a posttest-only design with nonequivalent groups. Participants included 34 primigravida and multigravida women who were then divided into intervention group who received dates milkshake and control group who received local fruit juice, each with 17 participants. Daily routine consumption and the partographs during labor were observed. The data obtained was analyzed using Mann Whitney and Cochran’s and Mantel-Haenszel.Results: The duration of labor in mothers given dates milkshake averaged 4.1 hours (± 0.697), ranging from 3 to 5 hours; meanwhile the control group averaged 7 hours (± 1.904), ranging from 5 to 11 hours. There was a significant difference in the duration of labor between mothers given dates milkshake and local fruit juice (p= 0.000, OR=4.0).Conclusions: Dates milkshake has an effect on shortening the duration of the first stage of labor. Dates milkshake can be used as a viable food choice for pregnant women to help maintain and increase maternal energy availability during childbirth.
... It was reported that maternal cervical dilatation (CD); delivery mode; and/or the score of neonatal appearance, pulse, grimace, activity, and respiration (APGAR) did not significantly change between parturients who ingested DPF in late pregnancy or labor and those who only received routine obstetric and nursing care [28][29][30]. Besides, no substantial differences were reported in the length of labor stages between the dates consumption and control groups [28,29,[31][32][33][34][35][36][37]. Further, the efficacy of using DPF on labor bleeding or PPH was similar to standard care [28,29,38,39]. ...
... Four trials measured gestation duration following eating DPF in pure form during late pregnancy [28,31,56,66]. Based on the meta-analysis, dates consumption had a low but significant effect on reducing gestation duration compared to the standard care (three RCTs and one non-RCT, WMD= ˗1.97 days; 95% CI [˗3.24 to ˗0.69 days]; P= 0.003). ...
... Based on the meta-analysis, dates consumption had a low but significant effect on reducing gestation duration compared to the standard care (three RCTs and one non-RCT, WMD= ˗1.97 days; 95% CI [˗3.24 to ˗0.69 days]; P= 0.003). After excluding only non-RCT [31], the overall estimation stayed significant for the remaining three RCTs (Fig. 1: a). Nevertheless, sensitivity analysis revealed the dependency of the overall pooled ES on the study by Kordi et al. [56] (WMD= ˗0.78 days; 95% CI [˗2.98 to 1.41 days]) (Supplementary Fig. 2: a). ...
... It was reported that maternal cervical dilatation (CD); delivery mode; and/or the score of neonatal appearance, pulse, grimace, activity, and respiration (APGAR) did not significantly change between parturients who ingested DPF in late pregnancy or labor and those who only received routine obstetric and nursing care [28][29][30]. Besides, no substantial differences were reported in the length of labor stages between the dates consumption and control groups [28,29,[31][32][33][34][35][36][37]. Further, the efficacy of using DPF on labor bleeding or PPH was similar to standard care [28,29,38,39]. ...
... Four trials measured gestation duration following eating DPF in pure form during late pregnancy [28,31,56,66]. Based on the meta-analysis, dates consumption had a low but significant effect on reducing gestation duration compared to the standard care (three RCTs and one non-RCT, WMD= ˗1.97 days; 95% CI [˗3.24 to ˗0.69 days]; P= 0.003). ...
... Based on the meta-analysis, dates consumption had a low but significant effect on reducing gestation duration compared to the standard care (three RCTs and one non-RCT, WMD= ˗1.97 days; 95% CI [˗3.24 to ˗0.69 days]; P= 0.003). After excluding only non-RCT [31], the overall estimation stayed significant for the remaining three RCTs (Fig. 1: a). Nevertheless, sensitivity analysis revealed the dependency of the overall pooled ES on the study by Kordi et al. [56] (WMD= ˗0.78 days; 95% CI [˗2.98 to 1.41 days]) (Supplementary Fig. 2: a). ...
Background
Recent reviews have reported inconclusive results regarding the usefulness of consuming dates (Phoenix dactylifera L. fruit) in the peripartum period. Hence, this updated systematic review with meta-analysis sought to investigate the efficacy and safety of this integrated intervention in facilitating childbirth and improving perinatal outcomes.
Methods
Eight data sources were searched comprehensively from their inception until April 30, 2023. Parallel-group randomized and non-randomized controlled trials published in any language were included if conducted during peripartum (i.e., third trimester of pregnancy, late pregnancy, labor, or postpartum) to assess standard care plus oral consumption of dates versus standard care alone or combined with other alternative interventions. The Cochrane Collaboration’s Risk of Bias (RoB) assessment tools and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were employed to evaluate the potential RoB and the overall quality of the evidence, respectively. Sufficient data were pooled by a random-effect approach utilizing Stata software.
Results
Of 2,460 records in the initial search, 48 studies reported in 55 publications were included. Data were insufficient for meta-analysis regarding fetal, neonatal, or infant outcomes; nonetheless, most outcomes were not substantially different between dates consumer and standard care groups. However, meta-analyses revealed that dates consumption in late pregnancy significantly shortened the length of gestation and labor, except for the second labor stage; declined the need for labor induction; accelerated spontaneity of delivery; raised cervical dilatation (CD) upon admission, Bishop score, and frequency of spontaneous vaginal delivery. The dates intake in labor also significantly reduced labor duration, except for the third labor stage, and increased CD two hours post-intervention. Moreover, the intervention during postpartum significantly boosted the breast milk quantity and reduced post-delivery hemorrhage. Likewise, dates supplementation in the third trimester of pregnancy significantly increased maternal hemoglobin levels. The overall evidence quality was also unacceptable, and RoB was high in most studies. Furthermore, the intervention’s safety was recorded only in four trials.
Conclusion
More well-designed investigations are required to robustly support consuming dates during peripartum as effective and safe integrated care.
Trial registration
PROSPERO Registration No: CRD42023399626
... Spontaneous births occurred in 96% of pregnant women who have consumed dates compared to 79% of pregnant women who did not. [10][11][12] Dates contain high proportions of carbohydrates, B vitamins, calcium, magnesium, potassium, and phytochemicals (carotenoids, polyphenols, tannins, and sterols), which have been shown a beneficial effect for health, especially pregnant women. These fruits have been traditionally consumed during pregnancy or the postpartum as one of the most common fruits in various regions across Asia and Africa. ...
... 20 Thus, several important issues that should be highly considered during the labor process, include the need for fluid nutrition and energy intake from decomposing semi-solid foods, such as Kusuma milk-shake, all of which are to support the mother's caring and loving attitude, as well as a gentle delivery process without other interventions, that may endanger the safety of mother and fetus. 11,17,21 Dates contain certain stimulants that strengthen the uterine muscles in the last few months of pregnancy, specifically strengthening uterine contractions during labor. 18 Dates are known as fruits with high nutrient content, such as carbohydrates, fiber, calcium, potassium, B complex vitamins, magnesium, and iron. ...
... Moreover, the use of oxytocin for labor induction was significantly lower in women who consumed dates (28%) compared to women who did not (47%), and the latency period was shorter in pregnant women who consumed dates. 10,11 The limitation of the study is the fact that the exact macro and micro nutrient have not been fully explored. Collaboration for further study on the potential of dates is needed to design the Kusuma milk-shake industry. ...
Background: Labor processes require energy consumption regulated by a complex nervous system and hormonal response. Thus, the intensity of maternal nutritional intake since pregnancy should be highly considered for physiological delivery. Nutrients that are high in energy and provide fast-decomposing glucose intake should be chosen by the mothers. Kusuma is a kind of drink made from dates, milk, and honey. This study aimed to analyze the effect of Kusuma milk-shake drink implementations on cervical dilatation and duration of labor.
Methods: An experimental study was conducted by post-test only with a controlled group design, including 34 mothers with term pregnancy, which was intervention groups and controls. A completely randomized design in two different places was conducted. Data were analyzed using Shapiro-wilk, independent sample T-test, and Mann-Whitney.
Results: There was a significant effect of Kusuma milk-shake implementation on cervical dilatation (p=0.000). The dilatation process was found to be 5.5 times faster, and the duration of labor (p=0.000) was observed to be 9.7 hours faster than the control group.
Conclusions: Implementation of the Kusuma milk-shake has a significant effect on the acceleration of cervical dilation and the duration of labor. This research is expected to improve the quality of midwifery services as an effort to realize the concept of a Continuum of Obstetric Care.
... Published clinical studies tend to emphasize the use of date fruit as a key ingredient during gestation, delivery, and after birth. As such in a prospective study conducted by Al-Kuran et al. (2011), it was reported that the 69 women who consumed 6 dates daily, 4 weeks prior to birth showed a higher average cervical dilation of 3.52 cm compared to the control group, with 2.02 cm leading to spontaneous labor in the experimental group (96% v/s 79%) (Al-Kuran et al. 2011). Furthermore, the Bishop score was higher in the intervention group (7.62 ± 2.28 v/s 5.12 ± 2.77), whereby 210 women with singleton pregnancy ate 75 g dates daily. ...
... Published clinical studies tend to emphasize the use of date fruit as a key ingredient during gestation, delivery, and after birth. As such in a prospective study conducted by Al-Kuran et al. (2011), it was reported that the 69 women who consumed 6 dates daily, 4 weeks prior to birth showed a higher average cervical dilation of 3.52 cm compared to the control group, with 2.02 cm leading to spontaneous labor in the experimental group (96% v/s 79%) (Al-Kuran et al. 2011). Furthermore, the Bishop score was higher in the intervention group (7.62 ± 2.28 v/s 5.12 ± 2.77), whereby 210 women with singleton pregnancy ate 75 g dates daily. ...
... Furthermore, the Bishop score was higher in the intervention group (7.62 ± 2.28 v/s 5.12 ± 2.77), whereby 210 women with singleton pregnancy ate 75 g dates daily. Both Kordi et al. (2014) and Al-Kuran et al. (2011) revealed an increase in cervical dilation after consumption as well as higher labor progression compared to the placebo group (66.7% v/s 60.0%). However, it is important to note that the form of date taken was not similar. ...
Appraised for being one of the oldest staple nutritive foods mainly in the Arabian Peninsula, the date palm tree (Phoenix dactylifera L.), is a crop native to the subtropical and tropical regions of Southern Asia and Africa. Different parts of the date tree have been extensively studied for their nutritional and therapeutic properties. Despite an array of publications on the date tree, there has been no attempt to compile in a single study the traditional uses, nutritive value, phytochemical profile, the medicinal properties as well as the potential of the different plant parts as a functional food. Therefore, this review endeavors to systematically review the scientific literature to highlight the traditional uses of date fruit and parts around the world, the nutritional profile of several parts and the medicinal properties. A total of 215 studies was retrieved (traditional uses (n = 26), nutritional (n = 52), and medicinal (n = 84)). Scientific articles were further categorized as in vitro (n = 33), in vivo (n = 35), and clinical (n = 16) evidences. Date seeds were found to be effective against E. coli and Staphylococcus aureus. Aqueous date pollen was used to manage hormonal problems and boost fertility. Palm leaves showed anti-hyperglycemic effects via inhibition of α-amylase and α-glucosidase. Unlike previous studies, this study highlighted the functional roles of all the plant parts of the palm tree and provided insights into the various mechanism of action of their bioactive compounds. Although scientific shreds of evidence have been growing over the years, there is still a dearth of studies concerning the clinical validation of the date fruit and other plant parts to provide strong evidence on their medicinal uses. In conclusion, P. dactylifera can be regarded as a potent medicinal plant with prophylactic potential and should be further explored to alleviate the burden of both communicable and non-communicable diseases.
... This applies to all types of parity, whether primiparous, multipara, or nulliparous. (4,(9)(10)(11)(12)(13)(14)(15)(16)(17) Two of the ten journals revealed that consuming dates, both Ajwa dates (Phoenix dactylifera L.) and ...
... (9,16) In addition, five of these journals examined the effect of Ajwa dates on the duration of the first stage of labor and reported that the average duration of the first stage of labor among consumers of Ajwa dates was significantly shorter than those who did not consume Ajwa dates at all. (4,(9)(10)(11)(12) However, there are many limitations in these studies which can increase the risk of bias in the research results. As it is not known for certain the number of dates that must be given in order to have a positive impact, the optimal length of time for giving dates, and the attention given to the intervention group tends to be more than the other participants. ...
... As it is not known for certain the number of dates that must be given in order to have a positive impact, the optimal length of time for giving dates, and the attention given to the intervention group tends to be more than the other participants. (4,(10)(11)(12) In a similar study, but using different variables, namely using other types of dates (Tunisia dates, Sukari dates, rotana dates, and Mazafati bam dates) by looking at their effect on the duration of the first stage of labor, it was found that these dates also provide a positive impact on labor progress. Five out of ten journals revealed that the duration of the first stage in participants who consumed dates shortened or became shorter than those who did not consume dates. ...
Background: Parturition is the process of expelling the products of conception that begins with the first stage of the process. The length of the first stage can be influenced by nutritional factors. Islam is a religion that also provides a solution by consuming Ajwa dates. Therefore, the researcher wants to write a scientific paper on "The Effect of Consumption Ajwa Dates to the First Stage of Labor". Content: Consumption of Ajwa dates during early delivery may shorten the duration of first stage labor in pregnant women. Conclusion: Ajwa dates (Phoenix dactylifera L.) have an indirect effect on uterine contractions as if increased of prostaglandin when we eat7 or 100rams of Ajwa dates (based on Rasulullah’s hadits) so the duration of the first-stage of labor in pregnant women who consume Ajwa dates is shorter than in pregnant women who do not consume them.
... 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. ...
... According to the results of Alkoran and colleagues (2011), cervical dilatation on admission was higher in the group consuming date fruit during late pregnancy, compared to the non-consuming control group (P<0.0005). 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). ...
... Given that the number of oxytocin receptors elevates in the last months of pregnancy, which itself leads to an increase of uterine sensitivity and contraction stimulation, date fruit can influence oxytocin receptors and accelerate the onset of uterine contractions more easily (10)(11)(12). Considering the limited research in this area and lack of such reports in Iran, we aimed to determine the effect of late-pregnancy consumption of date fruit on cervical ripening in nulliparous women. ...
its about effect of date fruit on labor and delivery
... Of 45 initial references, four articles were eligible for inclusion (Table 1). [12][13][14][15] Search results are presented in Supplementary Figure 1 and Supplementary Table 1. The studies were conducted in Jordan, Iran and Malaysia. ...
... One manuscript described the results of a prospective cohort study, in which the participants were offered to participate in one of two groups in open label fashion. 12 The remaining studies were conducted in a randomized controlled approach. ...
... Overall, 478 women were included in the analysis À 251 in date consumption group, and 227 in the control cohort. The groups were comparable in terms of maternal age and body mass index (two studies 13,15 ), gestational age at delivery (two studies 12,14 ) and birth weight. 15 Women consuming date fruit were admitted with higher cervical dilatation (MD 1.1 cm [95% CI 0.2 to 1.99 cm, three studies, I 2 93%, 450 women) and yielded a lower need for labor induction/augmentation (relative risk (RR) 0.6, 95% CI 0.43 to 0.83, three studies, I 2 51%, 478 women) (Fig. 1). ...
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
... Herbal remedies, such as the use of dates, are known for their benefits. Many pregnant women use dates during the third trimester of pregnancy (and especially in the last few weeks of pregnancy) to facilitate labor (Al-Kuran et al. 2011). The efficacy of date fruit consumption during the last month of pregnancy minimizes the need for induction and enhances the onset of labor (Al-Kuran et al. 2011). ...
... Many pregnant women use dates during the third trimester of pregnancy (and especially in the last few weeks of pregnancy) to facilitate labor (Al-Kuran et al. 2011). The efficacy of date fruit consumption during the last month of pregnancy minimizes the need for induction and enhances the onset of labor (Al-Kuran et al. 2011). Date fruit enhances the nutritional status of pregnant women as it helps in preventing anemia, regulating blood sugar levels, and helps to restore depleted calcium stores. ...
... Date fruit contains simple sugars that are a readily accessible energy source, strengthen uterine muscles, and provide energy to the mother during labor. It also contains hormones that help the uterus to stretch in preparation for delivery [48][49][50][51]. This section describes the health-promoting properties of bioactive components present in date palm attributed towards the betterment of fertility ( Moreover, early Egyptians and Chinese people used DPP as a rejuvenating medicinal agent and it is currently used as a dietary supplement globally [52]. ...
... Findings showed that date consumption reduces the need for labor augmentation but does not expedite the onset of labor [90]. Al-Kuran et al. [50] conducted a study to show the effect of date fruit on female labor parameters and delivery outcomes (n = 69). In the date fruit group, cervical dilation was also significantly increased, the requirement of oxytocin/protein was 28%, there was a higher rate of spontaneous labor, and the latent phase of the first stage of labor was shorter, as compared to the non-date fruit group. ...
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.
... Joshanda-i-Khurma helps to treat diarrhoea particularly in children. 15,24 • Bawāsīr Dāmiya (Bleeding piles): Use of date fruit with Sharab-i-Afis is useful in bleeding piles. 22 ...
The date palm (Phoenix dactylifera L.) is recognized as one of humanity's earliest cultivated plants, having served as a food source for over 6000 years. It holds a prominent status as the most favoured fruit in the Middle East and North Africa. Date fruit has a long history of consumption and traditional medicinal use. Whether eaten fresh or dried, dates offer a rich source of energy due to their exceptional nutritional content and extended shelf life. They provide an economical means of obtaining essential nutrients including carbohydrates, proteins, vitamins, minerals and dietary fibers. Furthermore, date fruit exhibits a diverse range of pharmacological effects including antimicrobial, anti-inflammatory, anti-diabetic, anticancer, antihyperlipidemic and many more. It is also beneficial in disorders of paralysis, sexual debility, fever etc. Date palm fruits offer a natural and safe alternative or complement to synthetic drugs in managing numerous health conditions. Keywords: Dates, Phoenix dactylifera, Arecaceae/Palmae, Khajur, Unani Medicine.
... A variety of medicinal herbs promote the stimulation of all stages of labor. According to a significant and groundbreaking study on the role of date seeds in labor, they showed a significant impact on the reduction of initialization and labor rise in women who consumed dates versus those who did not (Al-Kuran et al. 2011). This was evidenced by greater mean cervical dilatation. ...
Date palm (Phoenix dactylifera L.) is a very vital crop tree in many Middle Eastern countries and also, its fruits called dates are consumed worldwide by thousands of people. Date seeds which are the by-product of date fruits, are usually regarded as wastes and at most, only used as feed for farm animals. Unbeknownst to many however, date seeds are embedded with numerous amounts of fiber, carbohydrates, protein, oil, and dietary additionally, date seeds also contain phytochemicals that may elicit biological effects. Moreover, the abundant chemical composition of date seeds makes them apposite for use in medical supplements, food product formulation and cosmetics. It is the aim of the authors to review to the latest data on the pharmacological properties of date seeds discussing the botanical properties and industrial applications as well.
... По этим данным учёные сделали вывод, что употребление фиников в последние 4 недели перед родами значительно снизило потребность в медицинском вмешательстве и контроле процесса родов 27] . ...
В статье рассмотрены основные свойства финика и его воздействие на организм человека. Проведен систематический обзор современной специализированной литературы и актуальных научных данных. Указан химический состав и пищевая ценность плодов, рассмотрено использование финика в различных видах медицины и эффективность его применения при различных заболеваниях. Отдельно проанализированы потенциально неблагоприятные эффекты финика на организм человека при определенных медицинских состояниях и заболеваниях. Рассмотрены научные основы диет с его применением. Расширенная HTML версия статьи приведена на сайте edaplus.info.
... This superfruit is also fundamental and crucial to maintain the proper function of heart and to conserve the energetic status of the brain, especially to increase its capacity of memorization, concentration and learning processes [7]. It is also recommended to eat dates in order to prevent constipation [8,9]. ...
Date fruit is a functional food endowed with several pharmacological properties resulting from its diversified composition of nutrients and secondary metabolites. It is often stored for long periods after its harvest; however its initial nutritional and organoleptic properties are not always preserved. This study aimed to test the effect of three doses of radiations (0.6, 1.3, 2 kGy) on some nutritional and organoleptic properties of stored Deglet Nour and Ghars dates during ten months. pH, titratable acidity, and contents of total polyphenols, flavonoids and ascorbate as well as scavenging activity of date extracts have been periodically tested adopting appropriate methods. Radiation slowed, regardless of dose, a decrease in pH of Deglet Nour samples stored at low T, also the decrease in pH of Ghars samples (0.6, 1.3 kGy) stored at room T and (1.3, 2 kGy) at low T. Oscillations of decreases and increases of titratable acidity rates were obtained comparing to controls, but the treatment effectively increased, independently of the dose, the titratable acidity levels of Ghars samples during storage at low temperature. Doses 2 kGy at low T and 0.6 kGy at ambient T slowed down the decrease in polyphenols content of Deglet Nour samples (39.96%, 34.88%) versus controls (80.39%, 87.58%) respectively. However, TPC of Ghars samples underwent a progressive increase at ten months of storage ranging from 145.22 mg obtained before exposure to radiation to a level of 389.55 mg (2 kGy) at room T and a maximum of 256.22 mg (0.6 kGy) at low T. Deglet Nour samples irradiated at 0.6 and 2 kGy retained more flavonoids contents for both storage temperatures. Ghars samples, 2 kGy at room T and 0.6 kGy at low T, considerably increased flavonoids contents after ten months of storage. More pronounced increase was obtained for Deglet Nour samples (2 kGy) till 2.5 months of storage at room T, whereas, all samples gave significant increase until 5 months at low T. Up to 5 months at room T and 7.5 months at low T, irradiated Ghars samples 0.6 kGy of Deglet Nour stored at ambient T preserved its initial antiradical activity besides the slow- ing down of decrease of all irradiated samples. In addition, a considerable increase was observed for Ghars irradiated samples regardless of dose and involvement of phenolics in this activity was confirmed.
... women in the Control-Group had a spontaneous vaginal delivery, 6(8.5%) had an instrumental vaginal delivery, and 21(30%) underwent a cesarean section. According to a case-control study conducted in Jordan by Al-Kuran et al. 15 sixty-nine pregnant women who consumed six pieces of date fruits daily for four weeks in the third trimester were compared to controls who consumed no date fruits. It was found that the duration of the latent phase of the first stage was shorter in the date fruit consumers. ...
Objective: To assess the effect of date fruit consumption in late pregnancy on the onset and progress of labour, the need for induction and augmentation, and delivery outcomes. Study Design: Randomized controlled trial (NCT05105893). Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2021. Methodology: One hundred and forty women were randomized into equal-strength Experimental and Control Groups (70 in each Group). The Experimental-Group included those pregnant females who were advised to consume seven dates per day from 35 weeks onwards till the spontaneous onset of labour. In contrast, the Control-Group comprised primigravidae who did not consume dates in later pregnancy. Results: Spontaneous onset of labour was reported in 59(84.2%) pregnant women of the Experimental-Group compared to 43(61.4%) of Control-Group. 55(78.5%) pregnant women who consumed date fruit had a spontaneous vaginal delivery,4(5.7%) required instrumental delivery, and 11(15%) ended up having a caesarean section, whereas 43 out of 70(61.4%) women of the Control-Group had a spontaneous vaginal delivery, 6(8.5%) had an instrumental vaginal delivery, and 21(30%) underwent a cesarean section. Conclusion: The patients who had consumed date fruit in later pregnancy had an improved Bishop score at the onset of labour, a shorter duration of labour, a lesser need for induction and augmentation of labour and more spontaneous vaginal deliveries.
... Alguns problemas de saúde foram relatados como tratáveis pela utilização da tâmara e implementação da dieta. Estes variam desde o alívio da inflamação, laxante da constipação, promoção da saúde e força óssea, controle de distúrbios intestinais, melhora daqueles com anemia; saúde do sistema nervoso; cegueira noturna; diarreia; ao câncer abdominal (AL-SHAHIB;MARSHALL, 2003;AL KURAN et al., 2011). ...
... One trial reported spontaneous labour in 96% of those who consumed 76 grams dates, compared with 79% in the non-date consumers (p = 0.024). The mean duration of first stage of labour was shorter in women in the former compared to the later (510 min vs 906 min, p = 0.044) 7 . Another study reported that spontaneous labour occurred in 88%, with mean duration of first stage of labour was 255±172min of date consumers, compared to 84% spontaneous labour (p = 0.400), with mean duration of the first stage of labour 280±174min in non-dates consumers (p=0.569) in non consumers , while good Apgar score was equal i.e. 98.7% vs. 98.7% in both groups (p=0.605) 3 . ...
Background: Effect of dates on pregnancy outcomes is in debate among researchers for optimum results. Aim: To compare the fetomaternal outcome with and without use of dates in primigravidae presenting at 37-38 weeks Main outcome: The outcome was measured as fetal (Apgar score at 5 min) and maternal (onset and induction of labor) parameters. Study design: Randomized controlled trial Setting: Department of Obstetrics and Gynaecology, District Headquarter Hospital, Gujranwala Duration of study: 6 months 1st January 2020 to 30th June 2020 Methods: A total of 110 patients reporting to OPD in their first pregnancy between 18 to 35 years of age at 37 to 38 weeks were included whereas multigravidae and those with previous miscarriage were excluded. Consecutive Non Purposive Sampling technique was used and patients were randomly divided in two groups of 55 each. Group A consumed dates in late pregnancy while Group B was asked not to. Duration of first and second stage of labour and Apgar score at 5 minutes were recorded. SPSS version 21 was used to enter and analyze the data. Quantitative variables Apgar score were presented in the form of mean ± SD. Qualitative variables like spontaneous labour, need for induction and good Apgar score were presented in the form of frequency and percentage. Chi-square test was applied to compare spontaneous labour, need for induction, and good Apgar score in both groups. P-value ≤0.05 was taken as significant. Results: The mean apgar score at five minutes was 8.76±1.157. The analysis of qualitative variables showed that spontaneous labor was started in 75(68.2%) of patients and induction was required in 35 (31.8%) patients. There was successful induction in 1 (9.1%) of patients. At five minutes 101(91.8%) of neonates showed good apgar i.e. >7. Both groups were compared among each other in terms of both quantitative and qualitative variables. The onset of spontaneous labor, success of IOL and good apgar score at 5 minutes were compared among groups. The was significant difference among groups A and B in terms of these parameters except good apgar score i.e. p values of 0.008, 0.021 and 0.297 for spontaneous labor, IOL and good apgar scores Good apgar score at 5 min was not statistically significant among any stratification group. Conclusion: The consumption of dates significantly improves the fetomaternal outcomes in primigravida term pregnancies. The results should be validated in large randomized controlled trials. Keywords: Date fruit, Labour outcomes, Labour progression.
... Kordi et al. [8] found that consumption of dates-honey syrup during labor reduced the duration of the active phase of labor. However, Al-Kuran et al. [26] found consumption of dates during pregnancy did not affect the duration of the first, second, and third stages of labor (p > 0.05). Although Razali et al. [5] illustrated that consumption of dates during late pregnancy period and before labor decreased the need to administer oxytocin and prostaglandins during labor and increased the amount of non-induced delivery, it did not affect the duration of the first, second, and third stages of labor. ...
Background:
Assessing the progress of labor is a primary step in intrapartum care. This study was performed to assess comparison of the effects of date syrup with saffron-honey syrup on the progress of labor in nulliparous women.
Materials and methods:
A randomized single-blind clinical trial study was conducted on 189 women who were referred to Bea'sat Hospital of Sanandaj from October 2019 to March 2020. Patients were randomly divided into three groups saffron-honey syrup, date syrup, and placebo syrup each including 63 cases. Each participant in the intervention and control groups received a maximum volume of 150 ml of saffron-honey syrup, date syrup, or placebo syrup. The syrups were given at the 4 cm dilation, and every 30-60 min until the end of the active phase of the first stage of labor. Data collection tools included a two-part questionnaire and a partograph form. The results were analyzed by Statistical Package for the Social Sciences (SPSS) 24 using Chi-squared test, analysis of variance, and last significant difference as a post hoc test, the significance level was set at 0.05.
Results:
The duration of the active phases of the first (F 2 = 92.70, p < 0.01), second (F 2 = 66.76, p < 0.01), and third (F 2 = 12.34, p < 0.01) stages of labor was shorter in the date syrup and saffron-honey syrup groups than in the control group (p < 0.01). Additionally, both experimental groups exhibited no significant difference in terms of duration between the first (p = 0.312), second (p = 0.724), and third (p = 0.911) stages of labor.
Conclusions:
Date syrup and saffron-honey syrup can be used as one of the safe and available herbal methods to facilitate labor.
... Quercetin, luteolin, apigenin, chrysoeriol, kaempferol, isorhamnetin, 3-methyl-isorhamnetin, sulphates, and malonyl derivatives are the primary phenolic compounds found in date fruit. Date cultivars were high in phenolics, flavonoids, flavanols, and condensed tannins, all of which can inhibit the action of reactive oxygen species, which are linked to human ailments like heart disease and cancer (Al-Kuran et al., 2011) [12] . The role of polyphenols in date fruits is prevent against decease, date cultivars were high in phenolics, flavonoids, flavanols, and condensed tannins, all of which can inhibit the action of reactive oxygen species, which are linked to human ailments like heart disease and cancer (Younas et al., 2020) [67] . ...
... There is some evidence to suggest cervical sweep may increase the chance of onset of spontaneous labour [19] but with conflicting reports on this amounting to unassisted delivery or certainty around perinatal safety [19]. Other adjunctive factors thought to help promote onset of spontaneous labour include exercise and walking [20], sexual intercourse [21][22] consumption of dates [23][24][25], raspberry leaf tea [26], pineapple and spicy foods and acupuncture [27]. However there is limited robust evidence to support these therapies, and there remains a paucity of known effective interventions to encourage the onset of spontaneous labour. ...
Objectives
The objective of this study was to:
1.Establish the median gestational age of spontaneous labour for low-risk nulliparas
2.Examine the variation in mode of delivery and short-term neonatal outcomes with gestation at onset of spontaneous labour
Study DesignThis is a retrospective observational cohort study conducted at a tertiary obstetric unit. The study population was 12, 323 low risk nulliparous women with singleton pregnancies who experienced spontaneous onset of labour. The study period was over seven years, from Jan 1st 2011 to 31st Dec 2017. Exclusion criteria were multiparity, multi-fetal pregnancy, booking after 14 weeks gestation, antepartum or intrapartum death, or any obstetric or fetal indication for delivery with the exception of post-maturity. Gestation of onset of spontaneous labour, demographic variables and maternal and neonatal outcomes were collected. .
The primary outcome was median gestational age at onset of spontaneous labour and its variation with maternal demographic variables. Secondary outcomes were mode of delivery and neonatal outcomes including low-apgar score and NICU admission.
Results
12, 323 patients were eligible for inclusion. Median gestation for onset of labour was 40.1 weeks gestation, with 80.5% of spontaneous labour occurs by 41+0 weeks gestation. The risk of assisted delivery (RR 1.32, 95% CI 1.23 – 1.42), caesarean section (RR 2.17, 95% CI 1.88-2.51) and low-apgar scores (RR 3.13 95% CI 1.50-6.55) increased significantly with spontaneous labour after 41 weeks’ gestation.
Conclusions
Nulliparous women with low-risk pregnancies are most likely to experience spontaneous labour between 40+0 and 40+6. 80.5% of spontaneous labour occurred by 41+0 weeks gestation. Assisted vaginal delivery, caesarean section and low-apgar scores were significantly more likely with spontaneous labour after 41 weeks’ gestation.
... In line with earlier studies from Palestine (Al-Ramahi et al., 2013), Iran (Khadivzadeh and Ghabel, 2012), Egypt (Orief et al., 2014) and Thailand (Kruekaew and Kritcharoen, 2018), the current findings indicate that increased and frequent consumption of dates was a common behaviour among women during the last month of pregnancy. An earlier clinical study suggested that dates are associated with a reduced need for induction and augmentation of labour (Al-Kuran et al., 2011). A less common CM reported by women from Egypt and Iran was the consumption of eggs to induce labour. ...
The prevalence of self-prescribed complementary medicine (CM) use is an area of concern across the Middle East. We conducted a descriptive qualitative study to describe women's use of CM during their childbearing years in Egypt, Jordan, Saudi Arabia and Iran. The study conducted using face to face audio-recorded interviews with 70 participants. Our findings showed that women used several herbal plants to ease pain and discomfort during menstruation and/or during pregnancy and in postpartum care. Acupuncture, meditation, and massage were less likely to be used by women. The impact of CM was often described in relation to perceived usefulness and safety of herbs. Cultural beliefs and roles of women contributed to the use of herbs among women. Given the high use of herbal medicine, there is a need for discussion about the potential of adverse effects of some plants or their metabolites following self-medication during the childbearing years.
... The sample size for the study was calculated with consideration of earlier conducted clinical studies on Ajwa (Kordi, 2014;Al-Kuran, 2011). The power of the study for a significant increase in HDL level was 80%, with 5% of the significance level. ...
Objective
Date palm is a significant crop mainly of hot regions and used as a traditional remedy for various ailments. Ajwa is a well-known functional food with an abundance of phytochemicals that possess different beneficial and medicinal properties. The study's objective was to calculate the impact of Ajwa consumption in a daily routine on lipid profile and HDL in the general population.
Methods
Randomized clinical trial was conducted for six weeks on participants, including both genders, with HDL levels below 40 mg/dl. The intervention group was advised to take Ajwa (70 gm) on an empty stomach in the morning for five days a week for six consecutive weeks with their routine diet and physical activity. The control group was advised not to make any changes in their diet and everyday life. Body weight, BMI, blood glucose, and lipid levels were recorded before and after the trial to evaluate the effect of Ajwa on these markers.
Result
The Ajwa intervention group showed a significant effect for total cholesterol, triglycerides, LDL, and HDL (p=0.001), representing that the Ajwa group showed more alterations than the control group. However, no significant interaction effect was identified for body weight, BMI, and blood glucose level for both Ajwa and the control group.
Conclusion
The study findings recommend that intake of Ajwa is well tolerated, and its inclusion in diet and routine life provides cardioprotection by improving the lipid profile and raising the sub-optimal HDL levels.
... In line with earlier studies from Palestine (Al-Ramahi et al., 2013), Iran (Khadivzadeh and Ghabel, 2012), Egypt (Orief et al., 2014) and Thailand (Kruekaew and Kritcharoen, 2018), the current findings indicate that increased and frequent consumption of dates was a common behaviour among women during the last month of pregnancy. An earlier clinical study suggested that dates are associated with a reduced need for induction and augmentation of labour (Al-Kuran et al., 2011). A less common CM reported by women from Egypt and Iran was the consumption of eggs to induce labour. ...
The prevalence of self-prescribed complementary medicine (CM) use is an area of concern across the Middle East. We conducted a descriptive qualitative study to describe women’s use of CM during their childbearing years in Egypt, Jordan, Saudi Arabia and Iran. The study conducted using face to face audio-recorded interviews with 70 participants. Our findings showed that women used several herbal plants to ease pain and discomfort during menstruation and/or during pregnancy and in postpartum care. Acupuncture, meditation, and massage were less likely to be used by women. The impact of CM was often described in relation to perceived usefulness and safety of herbs. Cultural beliefs and roles of women contributed to the use of herbs among women. Given the high use of herbal medicine, there is a need for discussion about the potential of adverse effects of some plants or their metabolites following self-medication during the childbearing years.
... Therefore, the tannin content of the Phoenix dactylifera can induce constrictions in the uterus and myometrium (20). Additionally, the consumption of Phoenix dactylifera diminish the need for induction and significantly lowers the oxytocin and progestin usage in postpartum (30). Moreover, the tannin content of Plantago major can decrease postpartum hemorrhage through the stimulation of estrogen receptors and contraction of myometrial and uterine smooth muscle (18). ...
Effect of Herbal Medicines on Postpartum Hemorrhage: A Systematic Review and Meta-Analysis
... 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. In the study reported in this article, Sakka et al. determined the effects of Fenugreek and date fruit consumption on breast milk quantity and infant weight. ...
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.
... Stimulating oxytoxin receptors in central nervous system decreases anxiety followed by initiation, progression, and acceleration of the delivery (Kordi et al., 2014). Date is effective in oxytocin receptors and causes more effective cervical dilutions; therefore, consumption of dates in late pregnancy will decrease the need for oxytocin and prostaglandins for induction and speeding up labor (Al-Kuran et al., 2011). Date fruit contain necessary and unnecessary fatty acids that can produce prostaglandins. ...
Background: The delivery process need a lot of energy from food. Juice preparation is one of the recommended food forms during labor. This study was purposed to analyze the effect of giving mixed juices of young green coconut and dates on the duration of the active phase of the first stage of labor. Methods: A quasi-experiment with a post-test only with control group design include 18 pregnant women (10 intervention and 8 control. Purposive sampling was used, respondents were multigravida (P2-P4) in active phase of labor, without previous section caesarean, no augmentation with oxytocin, estimated birth weight was 2500-4000 gr, singleton pregnancy, aterm labor, and without any other complication during delivery at Alian Public Health Center, Kebumen Regency in October - December 2020. The intervention group given 500 mL of mixed juice of young green coconut and dates during the first stage of labor and control group received standard care. Mann-Whitney test was used to analyze median difference between two groups. Results: There was no difference in the duration of the active phase of the first stage of labor between the intervention and control group (P-value 0,756). There was no difference of the rate of cervix dilatation between the two groups (P-value 0,408). The median of the active phase of the first stage of labor was 197,5 minutes and 147,5 minutes respectively. The median of rate cervix dilatation in the intervention group was 1,96 cm per hour and 1,94 cm per hour respectively. The rate of cervix dilatation in both groups was in normal category. Respondent in standard group was not forbidden eating and drinking, so both groups received enough energy and hydration during labor. Conclusion: Mixed juice of young green coconut and dates can be given during labor to fulfill the energy need during labor.
Background
This work delves into the relationship between cardiovascular health (CVH) and aging. Previous studies have shown an association of ideal CVH with a slower aging rate, measured by epigenetic age acceleration (EAA). However, the causal relationship between CVH and EAA has remained unexplored.
Methods and results
We performed genome-wide association studies (GWAS) on the (12-point) CVH score and its components using the Taiwan Biobank data, in which weighted genetic risk scores were treated as instrumental variables. Subsequently, we conducted a one-sample Mendelian Randomization (MR) analysis with the two-stage least-squares method on 2383 participants to examine the causal relationship between the (12-point) CVH score and EAA. As a result, we observed a significant causal effect of the CVH score on GrimAge acceleration (GrimEAA) (β [SE]: − 0.993 [0.363] year; p = 0.0063) and DNA methylation-based plasminogen activator inhibitor-1 (DNAmPAI-1) (β [SE]: − 0.294 [0.099] standard deviation (sd) of DNAmPAI-1; p = 0.0030). Digging individual CVH components in depth, the ideal total cholesterol score (0 [poor], 1 [intermediate], or 2 [ideal]) was causally associated with DNAmPAI-1 (β [SE]: − 0.452 [0.150] sd of DNAmPAI-1; false discovery rate [FDR] q = 0.0102). The ideal body mass index (BMI) score was causally associated with GrimEAA (β [SE]: − 2.382 [0.952] years; FDR q = 0.0498) and DunedinPACE (β [SE]: − 0.097 [0.030]; FDR q = 0.0044). We also performed a two-sample MR analysis using the summary statistics from European GWAS. We observed that the (12-point) CVH score exhibits a significant causal effect on Horvath’s intrinsic epigenetic age acceleration (β [SE]: − 0.389 [0.186] years; p = 0.036) and GrimEAA (β [SE]: − 0.526 [0.244] years; p = 0.031). Furthermore, we detected causal effects of BMI (β [SE]: 0.599 [0.081] years; q = 2.91E-12), never smoking (β [SE]: − 2.981 [0.524] years; q = 1.63E-7), walking (β [SE]: − 4.313 [1.236] years; q = 0.004), and dried fruit intake (β [SE]: − 1.523 [0.504] years; q = 0.013) on GrimEAA in the European population.
Conclusions
Our research confirms the causal link between maintaining an ideal CVH and epigenetic age. It provides a tangible pathway for individuals to improve their health and potentially slow aging.
Dates, containing 80% sugar, offer an additional source of energy. This study seeks to ascertain the impact of date consumption on labor duration and postpartum blood loss volume among mothers who consumed dates at UPT Puskesmas Tunjung Teja in 2022. The study utilized a quasi-experimental design with a post-test only and a control group. The sample comprised 16 participants in the intervention group and 16 in the control group, selected using consecutive sampling. Research findings revealed that date consumption had a significant effect (p ? 0.05) on labor duration and blood loss volume during the fourth stage of labor. Data collection involved administering seven dates to mothers when their cervical dilation reached 1 cm upon admission. Healthcare providers at UPT Puskesmas Tunjung Teja are encouraged to offer dates as a nutritional supplement during labor to serve as a natural source of uterine energy. Abstrak: Buah Kurma mengandung 80% gula untuk penambah energi ekstra tinggi. Penelitian ini bertujuan untuk mengetahui efek konsumsi kurma pada kejadian lama persalinan dan volume darah kala IV pada ibu yang mengonsumsi kurma di UPT Puskesmas Tunjung Teja tahun 2022. Desain yang dipakai pada penelitian ini yaitu memakai desain penelitian quasi eksperimen dengan desain post-test saja dan kelompok kontrol. Jumlah sampel dalam penelitian ini yaitu 16 kelompok intervensi dan 16 kelompok kontrol, serta menggunakan teknik consecutive sampling. Hasil penelitian menunjukkan konsumsi kurma berpengaruh (p ? 0,05) terhadap lama persalinan dan volume perdarahan pada persalinan kala IV. Teknik pengambilan data penelitian ini adalah dengan memberikan 7 buah kurma kepada ibu saat hasil tes dilatasi serviks 1 cm saat responden datang. Petugas kesehatan di UPT Puskesmas Tunjung Teja disarankan untuk memberikan kurma sebagai asupan nutrisi saat melahirkan sebagai sumber energi alami rahim.
It is true that date palm (Phoenix dactylifera L.) holds a significant position in the life of Muslims, especially those of Arab culture, due to its cultural, religious, livelihood, and economic significance. It is an essential part of the diet and culture of Saudi Arabia, where the nutritious date palm fruits are typically eaten at the Rutab and Tamer stages. These fruits have been a staple food for Arabs since ancient times and have played a crucial role in improving food and nutritional security and economic circumstances. The functional characteristics and nutritional content of date palm fruits contribute significantly to improving general human health. Consuming an average of seven date fruits by adults can provide approximately 13%, 20%, and 25% of the recommended dietary allowance for energy, dietary fiber, and potassium, respectively. In addition to its nutrient-rich fruits, the date palm is also considered a significant natural renewable resource for many by-products, handicrafts, and architecture. The date palm contributes substantially to the socioeconomic development of nations, particularly Saudi Arabia. Ensuring food security has become a challenge that countries and organizations must address with possible solutions through increasing the cultivation of crops that are rich in nutrients and hold significant commercial values. The high-nutrient fruits of the date palm are a valuable contribution to achieving food and nutritional security at both local and global levels. The primary goal of this chapter is to highlight the research that has been conducted on date palm and its fruits in terms of their roles in food and nutritional security in Saudi Arabia’s diet, culture, life, economy, and society.
The present study aimed to investigate the effects of date fruit products on the childbirth process and pregnancy complications. MeSH keywords systematically were searched in scientific databases. Finally, 16 articles were reviewed. Overall results of studies illustrated that using seven date fruits per day(average of 80 grams per day) for 2 - 4 weeks before their estimated date of delivery leads to a better cervical dilatation at admission or improvement of bishop score, decrease in the need for induction or stimulation of labor and by increasing effective uterine contractions, decrease duration of pregnancy, and duration of the different stages of labor. Also, date fruit products can improve blood pressure parameters in pregnant women at risk of preeclampsia and accelerate episiotomy healing. Keywords: Pregnancy; Childbirth; Phoenix dactylifera; Date Fruits; Date Palm Fruit.
Latar Belakang Masalah : Melahirkan merupakan proses alami yang dialami oleh seorang ibu hamil. Selama tahap ini kemungkinan, beberapa masalah muncul, salah satunya adalah perpanjangan kala persalinan. Persalinan lama merupakan salah satu faktor penyebab kematian ibu yang mencapai 8% secara global dan 9% di Indonesia. Beberapa upaya agar persalinan dapat berjalan dengan lancar dapat dilakukan persiapan sejak kehamilan Nutrisi yang tepat, kebiasaan makan yang teratur, dan penambahan makanan tambahan selama kehamilan dapat membantu proses persalinan berjalan lancar. Tujuan : Penelitian ini dilakukan untuk mengetahui efektifitas pemberian supplementary feeding sari kurma terhadap tenaga meneran ibu hamil inpartu primigravida. Metode : Desain penelitain menggunakan analitik pre eksperimen dengan pretest posttest control group. Sampel 12 ibu inpartu primigravida dengan teknik pengambilan sampling menggunakan purposive sampling. Analisa data secara bivariat, dengan pengujian mengunakan uji statistik Independent sample t-test. Hasil: Uji t dengan (? 0,05) dari sampel yang diberi dan tidak diberi sari kurma dengan tabel t hasilnya (t=3,162, sig=0,025). Terbukti efektif supplementary feeding sari kurma terhadap tenaga meneran ibu inpartu primigravida. Kandungan sari kurma glukosa tinggi sederhana (glukosa, sukrosa dan fruktosa) sebagai sumber energi untuk mempertahankan energi tubuh saat melahirkan. Simpulan: Supplementary feeding sari kurma yang diberikan pada ibu menjelang persalinan dapat membantu menambah tenaga ibu saat meneran, sehingga proses persalinan dapat berjalan dengan lancar.
Pollination is one of the most important and laborious agronomical practices in date cultivation, without which it is difficult to get the desired yield. Date palm pollen (DPP) has a major influence on fruit quality, development, and yield, which are widely influenced by pollen structure, viability, and germination capability. Under commercial cultivation, growers need to manage pollen by storing it at a cool temperature and mixing it with various adjuvants to dilute the quantity of the pollen used for pollination. The success of the pollination is further influenced by the female flowers and their receptivity, and thus proper vigilance is required to note the time of anthesis of the female inflorescence. Over the years, methods of pollination have improved and with the usage of mechanized tools the laborious pollination process has been made easier. Apart from pollination, pollen also has secondary uses for various medical ailments such as male sterility. DPP is also a potential cause of various respiratory ailments such as asthma and thus requires careful handling. This chapter discusses the importance of pollen, its structure, its method of utilization, xenia and metaxenia effects, alternative uses, and associated probable problems.
Latar Belakang:Kurma Ajwaajwa atau disebut juga “kurma nabi” merupakan salah satu bahan makanan yang memiliki nilai spiritual bagi kaum muslimin. Disebutkan secara khusus dalam hadits shahih Nabi Muhammad SAW dan dijelaskan manfaat dan keutamaannya oleh para ulama. Isi:Kandungan nutrisinya yang lengkap, baik makronutrisi dan mikronutrisi menyebabkan kurma Ajwa memiliki aktivitas biologik pada tubuh manusia sehingga menimbulkan manfaat kesehatan. Salah satu manfaat kurma Ajwa adalah terkait dengan kesehatan reproduksi wanita; mencegah terjadinya persalinan memanjang, mencegah progresifitas preeklampsia, dan memperlambat penurunan AMH yang merupakan prediktor menopause pada wanita Masih perlu ditambahkan LB tentang penelitian terkait kesehatan reproduksi wanita. Kesimpulan: Berbagai penelitian ilmiah terkini menunjukkan bahwa kurma Ajwa adalah bahan makanan fungsional yang memiliki potensi bagi kesehatan reproduksi wanita.
Labor is a normal process characterized by uterine contractions that cause significant cervical dilatation accompanied by expulsion of the fetus and placenta from the woman's body. The progress of labor in the first stage is the most tiring, strenuous, and most mothers begin to feel pain or pain, in this phase most mothers feel severe pain because uterine activities begin to be more active. The active phase of the first stage of labor involves a lot of energy, so the nutritional needs of the first stage need special attention from the labor manager. One of the fruits that contain considerable energy is the date palm which contains fructose and glucose, all of which are energy sources that are easily absorbed by the body. Dates contain lots of carbohydrates, affect the progress and spontaneity of labor and reduce postpartum hemorrhage. Dates contain saturated and unsaturated fatty acids such as oleic, linoleic, and linolenic acids. Fatty acids in addition to providing and ordering energy, contribute to the delivery of prostaglandins. Therefore, dates can help in saving energy and strengthening the uterine muscles.
Date palm tree (Phoenix dactylifera L.) is considered as one of the oldest cultivated plants of humankind and used as food for 6000 years. It is mostly cultivated in many tropical and subtropical regions around the world. Date fruit is the ancient crops in Southwest Asia and North Africa, and can also be grown in Australia, Mexico, South America, Southern Africa, and the United States. The genus Phoenix contains 12 of 1500 species that belong to the Date palm family. Date fruit is consumed widely and has been used for traditional medicine purposes for a long time. Dates fruit are for multipurpose use, whether fresh or dried is the perfect source of energy because of its high nutritional value and its long life. Date fruit has many pharmacological actions like antimicrobial, anti-inflammatory, anti-diabetic, antiulcer, anticancer, antidiarrheal, antihyperlipidemic, haemopoietic, hepatoprotective, nephroprotective, and used in infertility, strengthening of oocytes and pregnancy, urinary complaints, respiratory diseases, paralysis, sexual debility, fever, infection, constipation etc. Date palm fruits are a safe, natural alternative and complementary treatment comparable with synthetic drugs to combat many disease conditions. The present review article enlightens the nutritional value and therapeutic uses of date fruit as mentioned in classical Unani text in a scientific manner.
Objective Dates are one of the oldest medicinal foods that contain natural sugars (sucrose, glucose, and fructose), vitamins, minerals, phenolic compounds, and high antioxidants. There is a wide range of secondary metabolites in dates including anthocyanins, carotenoids, flavonoids, phenolic acid, procyanidin, and sterols. These bioactive compounds have antioxidant, antimicrobial, anticancer, anti-inflammatory, and liver protection properties. This study aims to investigate the medicinal and nutritional values of dates in modern medicine and Iranian traditional medicine.
Methods In this review study, data were collected from traditional Iranian-Islamic medicine books (Quran, Makhzan-Al-Adviyeh) and all articles published from 2010 to 2021 in the field of clinical trials on humans and common diseases (Gynecological, cardiovascular, gastrointestinal inflammation, and brain disorders) and indexed in online databases (Google Scholar, PubMed, Ovid, MagIran) using specialized keywords.
Results Due to the antioxidant properties (flavonoid and polyphenolic), dates have been recommended for cardiovascular health, fertility, reduction of inflammation, digestive health, and brain health in modern medicine, and for treating weakness, memory instability, fever, pain, nervous disorders, male and female infertility, pertussis, and bladder pain as a sedative, expectorant, laxative, and diuretic product in traditional medicine (Iranian, Greek, Roman, Chinese and Indian). In Quran (Surah Maryam), it has been mentioned that dates fruit strengthens the contractile and cervical muscles in the last months of pregnancy. It also lowers the blood pressure in pregnant women for a short time, which reduces the amount of bleeding during childbirth.
Conclusion The results of studies indicate the medicinal and nutritional values of dates in improving the metabolic activities, especially the functions of heart, fertility, digestion, and brain.
Pendahuluan : Persalinan hal yang biasa dialami setiap wanita, prosesnya seringkali mengalami kendala yang tidak diinginkan salah satunya adalah persalinan lama. Selama proses persalinan memerlukan tenaga ibu untuk kala I pembukaan sedangkan tenaga ini didapatkan dari asupan makanan dan minuman, salah satu diantaranya yaitu pemberian sari kurma sebagai pengganti asupan energi pada ibu selama proses persalinan. Kandungan dalam sari kurma dapat membantu mengganti asupan gula pada tubuh. Metode : literatur yang diperoleh melaui media elektronik dengan penuntun kata kunci. Artikel yang terpilih berjumlah 5, yang didalamnya terdapat satu pengaruh pemberian sari kurma terhadap kemajuan persalinan kala I fase aktif pada primipara. Hasil : Dalam mempercepat proses persalinan diperlukan sari kurma untuk mempengaruhi reseptor oksitosin dan membuat rahim otot merespon lebih baik terhadap oksitosin, menghasilkan banyak kontraksi uterus yang lebih efektif. Pada fase kala I persalinan dibutuhkan kontraksi (power) yang adekuat untuk dapat memulai persalinan. Melemahnya kontraksi rahim atau kontraksi inadekuat ini merupakan penyebab terbanyak terjadinya partus lama. Pembahasan : Adapun salah satunya cara non farmakologi yang diberikan untuk kemajuan persalinan yaitu dilakukan pemberian sari kurma agar mempercepat kemajuan persalinan kala I fase aktif. Simpulan : Berdasarkan analisa yang telah dilakukan adalah pemberian pemberian sari kurma efektif dapat kemajuan persalinan kala i fase aktif pada ibu primipara.
Date palm tree (Phoenix dactylifera L.) is an important crop or khajoor in the local language which is cultivated in many countries. Different types of dates are present but Ajwa khajoor is very beneficial in cardiovascular activity, heart disease, antimicrobial, nephroprotective, antioxidant, anti-inflammatory activity, provide relaxation during pregnancy, reduce risk of tooth decay, improve bone health, and also provide mental clarity. Prophet Muhammad (Peace Be upon Him) said that the best assets are date palm, dates cure several disorders, and he suggested Muslims to eat the date and have a tendency the date palm. Dates play key role in anti-cancer activity, anti-tumor, cardio-protective activity, and neuroprotective activity. Dates fruits and seeds are considered essential nutrients and medicines. They can be used in a variety of cosmetic and beauty products. Many cosmetic products contain high levels of chemical compounds, commonly found in synthetics such as hydroquinone. Date seed oil has been shown to have a positive effect on human skin and hair, as well as a few products (body creams, soaps, hair products, and sunscreens) are sold. Seed oils have high oxidative properties, extended storage capacity, and can protect the skin from UV rays and repair it. Bioactive compounds, such as flavonoids and phenolics, can prevent hair loss and promote hair growth. The extracts from dietary seeds are rich in phytosterols, essential fatty acids, and nutrients needed to maintain healthy scalp, promote normal hair growth, and support nourishing functions of sebaceous glands and hair follicles. It is important to all synthetic skincare products and medically very beneficial.
Mother's Milk (ASI) is the best food for babies that is produced directly from the mother's breast to her newborn baby, because its composition is appropriate for every baby's growth and development, breast milk also contains protective substances that can prevent babies from various infectious diseases . Dates contain iron, protein, fiber, glucose, vitamins, biotin, niacin, folic acid, and minerals such as calcium, sodium, and potassium which can increase breast milk production . The purpose of this study was to determine the effect of dates on breast milk production in postpartum mothers on days 3-9 at PMB Binti Qoni'ah Nganjuk 2021. The design of this study was pre-experimental using a one-group pre-posttest design. In this study obtained a population of 15 people, with a sample of 15 people using total sampling technique. The data was collected using an observation sheet and the hypothesis test used was the Wilcoxon Signed Rank Test with a significance value = 0.05. The statistical test result from the Wilcoxon Sign Rank obtained p value = 0,01 with an error level (=0.05), it can be said that p < than it can be concluded that Ho is rejected and H1 is accepted. There is an effect of dates on breast milk production in postpartum mothers on days 3 - 9 at PMB Binti Qoni'ah Nganjuk 2021. Based on the results of the study, it is hoped that the research area can be used as input for using dates to increase breast milk production in the development of traditional medicine
Date palm (Phoenix dactylifera L.) products have been widely consumed for thousands of years in Islamic countries. It has many varieties in different countries including Ajwa, Bouskri, Bousrdon, Bousthammi, Boufgous, Jihl, and Medjool. Date palm is a useful traditional medicinal plant containing numerous bioactive compounds that have free radical scavenging, antioxidant, antimutagenic, antimicrobial, anti-inflammatory, antihyperlipidemic, gastroprotective, hepatoprotective, nephroprotective, anti-cancer, and immunostimulant activities. These biological activities are due to the nutritive and bioactive compounds that are present in its fruits, seeds, pollen, and other parts. Phoenix dactylifera contains fatty acids, amino acids, proteins, and steroidal substances of nutritive value. Also, it contains many valuable phytochemical constituents like phenolics, flavonoids, and carotenoids. More research is needed to investigate the pharmacological potentials of P. dactylifera bioactive constituents either in free- or in nano-forms. Therefore, we encourage researchers to investigate the molecular and biochemical effects of P. dactylifera supplementation on reproduction, hormonal homeostasis, intestinal nutrient transport proteins, apoptosis, and antiapoptotic molecules. In addition, the effect of P. dactylifera supplementation on glucose uptake by peripheral tissues with evaluation of glucokinase and hexokinase genes and protein expression is the main future recommendation of our study, in addition to the investigation of gluconeogenic, glycogenic, and glycogenolytic enzymes gene and protein expression. Finally, we encourage researchers to further determine the mechanisms by which P. dactylifera induces its biological activities.
Metabolomics identify and analyze, in a comprehensive and high throughput manner, all the metabolites of an organism including amino acids, organic acids, sugars, fatty acids, lipids, steroids, small peptides, vitamins and phenolics. By measuring global sets of low molecular weight metabolites, metabolomics provide a snapshot readout of metabolic activity status in relation to the genetic makeup of the variety, its natural gene expression or its response to external stimuli encountered where it is grown. When the snapshot readout can be associated with the outcome phenotype (e.g., healthy vs diseased; high vs low fruit sugar content), more high-throughput analytical techniques and tools can be combined with metabolomics to provide a better understanding of the physiological processes occurring in the studied variety. In date palm, the metabolome representing the pool of small molecules chemically distinct through their structure (fingerprint) or biochemically involved in certain pathways (precursors, substrates, products) has traditionally been used to identify biomarkers for diagnosis and prediction. In recent years, metabolomics has become essential not only to the identification of simple biomarkers but as a technology for discovering actives that drive physiological processes, help create new cultivars with desired attributes, or add value to harvested dates.
Bu çalışmanın çıkış noktasını -ikonografik bir değerlendirme olmaksızın- Karatepe emziren anne kabartması ve Leto’nun doğum mitosu özelinde hurma ağacının kadınlar ile olan ilişkisi oluşturur. Hurma ağacının Mezopotamya’da ortaya çıkan varlığı, onun önemli bir besin kaynağı olmasıyla güçlenmiş ve zamanla tek başına ya da tanrısal karakterle ilintili dinsel bir anlam kazanmasına da sebebiyet vermiştir. Bu bağlamda onun, Dumuzi, İnanna/İştar, Mulissu gibi tanrı ve tanrıçalarla yakın bir ilişkiye sahip olduğu anlaşılmıştır. Ne var ki, hem kutsalın kendisi hem de tanrının içinde algılandığı bir ağaç olarak hurmanın özellikle kadınlarla olan ilişkisinin ise çok daha derin bir anlam taşıdığına dair veriler mevcuttur. Mezopotamya yazılı belgelerinin aktardıklarına göre hurma zor doğumlarda kadınlara yardım eden ve aynı zamanda kadının besleyici gücüne katkı sağlayan bir ağaçtır. Diğer yandan dikkat çeken önemli bir nokta ise bu durumun bugünün modern tıp verileriyle de doğrulanmış olmasıdır. Dolayısıyla söylenebilir ki, hem Karatepe’de emziren bir anne kabartmasında, hem de bir Yunan mitosundaki doğum tasvirinde hurmanın görülme sebebi kadim halklarca bunun çoktan tecrübe edilmiş olmasından kaynaklanmaktadır
its about effect of date fruit on onset of labor
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.
Date fruit is an excellent source of nutritional and health benefits. The chemical composition of dates includes carbohydrates, dietary fibre, proteins, fats, minerals and vitamins, enzymes, phenolic acid and carotenoids, all of which are directly linked to nutritional and health benefits for consumers. A number of studies have also confirmed the therapeutic effects of dates and their efficacy in the treatment of many disease conditions. As a result, a number of food products such as date syrup, date juice and date paste have been developed in order to harness the nutritional potential of dates. Adequate sources of nutrition are important for all consumers, especially for active lifestyle individuals such as athletes and sportspeople. As the goal of every athlete is to enhance athletic performance and prevent energy deficit, the use of dietary supplements has been highly recommended as a solution in this regard. For example, nutrition bars are one source of high energy and nutrients that can provide the required energy for enhanced athletic performance, and date fruits could be valorised into nutrition bars in order to help athletes to achieve their performance and nutritional goals. In this paper, we review the chemical composition and health benefits of date fruit, its food application and consequently its formulation in nutrition bars for athletes.
As an alternative to providing energy during late pregnancy and childbirth, dates give many benefits, such as assisting contractions. Dates have high carbohydrate content so that fatigue that occurs during labor, especially in the active phase, can be reduced. By dividing the sample into two groups, namely the experimental group and the control group, the intervention of date palm juice was seen based on the duration of the active phase of labor. It was known that the experimental group had a shorter duration of labor than that of the control group with a p value equal to 0.000. Therefore, date juice is proven to shorten the duration of active phase labor.
Intrapartum use of oxytocin should entail controlled dosages administered through infusion, continual monitoring of mother and fetus and surgical back-up, since several adverse outcomes have been reported. However, in Uttar Pradesh, north India, small-scale ethnographic studies as well as a large-scale retrospective survey have established that unmonitored intramuscular oxytocin injections are commonly given to birthing mothers to augment labour by unregistered local male practitioners and auxiliary nurse-midwives employed by government during home deliveries. India’s reproductive and child health policy needs to address the inappropriate use of oxytocin. Under a new 2007 policy, female government health workers at peripheral institutions are to be supplied with oxytocin to inject during the third stage of labour to prevent post-partum haemorrhage. The practice of injecting oxytocin intrapartum could readily be reinforced by this policy shift. There is an urgent need to ensure that home births are safer for mothers and babies alike, since India’s current policy goals of raising the numbers of institutional deliveries, ensuring skilled attendance at birth and improving referrals for emergency obstetric care cannot be met in the foreseeable future. In a context of enduringly high infant and maternal mortality, especially in Uttar Pradesh and other large northern states, the question of whether or not inappropriate use of oxytocin is contributing to maternal and newborn morbidity and mortality deserves further research.
Résumé
Pendant l’accouchement, l’ocytocine doit être administrée à doses contrôlées et par perfusion, avec une surveillance permanente de la mère et du fłtus et une assistance chirurgicale, puisque des effets indésirables graves ont été notifiés. Néanmoins, dans l’Uttar Pradesh, en Inde septentrionale, des études ethnographiques à petite échelle et des enquêtes rétrospectives de grande envergure ont montré que des injections intramusculaires non surveillées d’ocytocine sont fréquemment administrées aux femmes pour accélérer le travail par du personnel masculin local non diplômé et des infirmières-sages-femmes auxiliaires employées par l’État pendant les accouchements à domicile. La politique indienne de santé génésique et infantile doit se pencher sur l’administration impropre d’ocytocine. En vertu d’une nouvelle politique de 2007, le personnel de santé féminin employé par l’État dans des institutions périphériques doit recevoir de l’ocytocine à injecter pendant le troisième stade de l’accouchement, pour éviter les hémorragies post-partum. Cette modification pourrait renforcer la pratique de l’injection d’ocytocine pendant l’accouchement. De plus, il est urgent de veiller à ce que les naissances à domicile deviennent plus sûres pour les mères et les bébés, puisque les objectifs actuels de l’Inde qui consistent à relever le nombre de naissances en milieu hospitalier, garantir une assistance qualifiée pendant l’accouchement et améliorer le transfert des urgences obstétricales ne seront pas atteints à brève échéance. Alors que la mortalité maternelle et infantile demeure élevée, particulièrement dans l’Uttar Pradesh et d’autres grands États du nord, la question de savoir si l’utilisation impropre de l’ocytocine contribue ou non à la morbidité et la mortalité de la mère et du nouveau-né mérite davantage de recherches.
Resumen
El uso de oxitocina intraparto debe implicar dosis controladas administradas por infusión, monitoreo continuo de la madre y el feto, y respaldo quirúrgico, dado que se han informado varios resultados adversos. Sin embargo, en Uttar Pradesh, en la India septentrional, los estudios etnográficos de pequeña escala, así como una encuesta retrospectiva de gran escala, han establecido que las inyecciones intramusculares de oxitocina sin monitoreo comúnmente son administradas por prestadores de servicios de sexo masculino no titulados y enfermeras-parteras auxiliares empleadas por el gobierno, durante el parto domiciliario a fin de aumentarlo. La política de la India en cuanto a la salud reproductiva y la salud infantil debe tratar el uso indebido de oxitocina. En conformidad con una nueva política de 2007, las trabajadoras de salud gubernamentales en instituciones secundarias deben ser suministradas con oxitocina para inyectarla durante la tercera etapa del parto a fin de evitar la hemorragia posparto. La práctica de inyectar oxitocina intraparto fácilmente podría ser reforzada por ese cambio en política. Existe una necesidad urgente de garantizar que el parto domiciliario sea seguro tanto para la madre como para el bebé, dado que en el futuro inmediato no es posible lograr los objetivos de la política actual de la India de incrementar el índice de partos institucionales, garantizar asistencia calificada durante el parto y mejorar las referencias para cuidados obstétricos de emergencia. En un contexto de mortalidad materna e infantil perdurablemente altas, especialmente en Uttar Pradesh y otros estados septentrionales importantes, la interrogante en cuanto a si el uso indebido de oxitocina contribuye o no a la morbimortalidad de madres y recién nacidos amerita ser investigada más a fondo.
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
The rate of labor induction nationwide increased gradually from 9.5% to 19.4% between 1990 and 1998. Reasons for this doubling of inductions relate to widespread availability of cervical ripening agents, pressure from patients, conveniences to physicians, and litigious constraints. The increase in medically indicated inductions was slower than the overall increase, suggesting that induction for marginal or elective reasons has risen more rapidly. Data to support or refute the benefits of marginal or elective inductions are limited. Many trials of inductions for marginal indications are either nonexistent or retrospective with small sample sizes, thereby limiting definitive conclusions. Until prospective clinical trials can better validate reasons for the liberal use of labor induction, it would seem prudent to maintain a cautious approach, especially among nulliparous women. Strategies are proposed for developing evidence‐based guidelines to reduce the presumed increase in health care costs, risk of cesarean delivery for nulliparas, and overscheduling in labor and delivery.
There still is no agreement as to whether oxytocin, given to induce or augment labor, should be continued after active labor begins. The question is an important one because of the risk of uterine hyperstimulation, which may compromise the fetus or cause dysfunctional labor. Even uterine rupture is a possibility. This prospective, randomized study enrolled 104 women admitted for induction of labor with oxytocin. None had more than 1 previous cesarean delivery, and multiple pregnancies and a nonvertex presentation precluded participation. Also excluded were cases with a nonreassuring fetal heart rate before induction or an estimated fetal weight exceeding 4250 g. Group A patients received oxytocin incrementally until 5 cm of dilation was achieved and then at the same rate throughout labor. In group B patients, oxytocin was withdrawn at 5 cm of cervical dilatation. Induction began by infusing 1 mIU/min of oxytocin and increasing the dose by 1 mIU/min at 20-minute intervals until contractions occurred regularly at a rate of 3 to 5 every 10 minutes. The maximum dose rate allowed was 20 mIU/min. In both groups, the major indications for inducing labor were postdate pregnancy and rupture of membranes. Groups A and B did not differ significantly in the condition of the cervix before induction, the course of labor, or the analgesia used during labor. The active phase of labor was shorter in group B, but not to a significant degree. Oxytocin was stopped in 4 group A women because of a nonreassuring fetal heart rate pattern. It was restarted in 4 group B women when uterine activity was inadequate and labor arrested. There were 6 cesarean deliveries in group A and 3 in group B. All section deliveries were done because of nonprogressive labor or a nonreassuring fetal heart rate pattern. There were no maternal or neonatal complications. It seems possible to suspend oxytocin infusion at the start of the active phase of labor without prolonging labor, and there is no apparent reason not to do so.
A prospective multicenter study of obstetric practices was conducted in three developing countries (Benin, Congo and Senegal) to analyze oxytocic use during labor. One of the objectives was to assess the possible negative effects of the treatment regimens instituted during the labor monitoring phase.
Four health districts participated in the study. All women who gave birth in one of the participating health facilities over a 6-month period in Benin and Congo, and over a 3-month period in Senegal, were recruited. The number of deliveries studied in each district varied from 457 to 1048. For each case a partogram was used to assess the progress of labor and the onset of dysfunctional labor. Information was collected on the risk factors for dysfunctional labor, stillbirths and resuscitation of the neonate.
Each of the four collaborating centers used oxytocics preferentially to treat dysfunctional labor, but even in normal labor (i.e. with a normal partogram) oxytocics were used in 4.4-21.5% of cases. In normal labor the incidence of neonatal resuscitation was higher in cases with than in those without oxytocic use: the relative risks (R.R.) varied from 1.9 to 5.6; the odds ratios varied from 2.4 to 7.0, and both were statistically significant in the four settings. In addition the stillbirth rate was always higher, though not significantly, when oxytocics were used in normal labor (R.R. 1.2-2.2). When the data of the four centers were pooled, the global relative risk for stillbirths was 1.9, and the 95% confidence interval was 1.1-3.4. Logistic regression analysis was carried out for five confounding factors (primiparity, a previous complicated delivery, presence of meconium, ruptured membranes and educational level) to adjust the odds ratio for the risk of neonatal resuscitation when oxytocics were used in normal labor. Except in the case of Abomey in Benin, where the variable 'presence of meconium' decreased the odds ratio from 6.4 to 3.4, the adjusted odds ratios remained similar to their non-adjusted values. In cases of non-dysfunctional labor, nurses and midwives used oxytocics more often than lesser trained health personnel (R.R. 4.0 [3.2-5.1]).
Our results show that an obstetric treatment which is safe when used in certain well-defined indications, may have significant negative effects when used in situations where the same technical quality of care cannot be guaranteed.
To compare intravenous oxytocin administration (Partocon 10 IU) with saline solution in the management of postpartum haemorrhage in the third stage of labour.
A double-blind, randomised controlled trial involving 1000 parturients with singleton fetuses in cephalic presentation and undergoing vaginal delivery, randomly allocated to treatment with oxytocin (n = 513) or 0.9% saline solution (n = 487).
Labour ward at a central county hospital.
Mean blood loss (total, and before and after placenta delivery); frequencies of blood loss > 800 mL, need of additional oxytocic treatment, postpartum haemoglobin < 10 g/dL; and duration of postpartum hospitalisation.
As compared with saline solution, oxytocin administration was associated with significant reduction in mean total blood loss (407 versus 527 mL), and in frequencies of postpartum haemorrhage > 800 mL (8.8% versus 5.2%), additional treatment with metylergometrine (7.8% versus 13.8%), and postpartum Hb < 10 g/dL (9.7% versus 15.2%), and a nonsignificant increase in the frequency of manual placenta removal (3.5% versus 2.3%). There was no group difference in the mean duration of postpartum hospitalisation (4.6 versus 4.5 days, respectively).
Administration of intravenous oxytocin in the third stage of labour is associated with an approximately 22% reduction in mean blood loss, and approximately 40% reductions in frequencies of postpartum haemorrhage (> 500 mL or > 800 mL) and of postpartum haemoglobin < 10 g/dL. Identification of risk groups for oxytocin treatment does not seem worthwhile. Oxytocin is a cheap atoxic drug and should be given routinely after vaginal delivery.
To test the hypothesis that high-dose oxytocin, when used in a masked fashion, would result in shorter labors and less need for cesarean delivery.
We conducted randomized, double-masked trials of high-dose compared with low-dose oxytocin for augmentation and induction of labor. Patients were randomly assigned to receive oxytocin by either a low-dose protocol (1.5 mU/minute initially, increased by 1.5 mU/minute every 30 minutes) or a high-dose protocol (4.5 mU/minute initially, increased by 4.5 mU/minute every 30 minutes). Oxytocin solutions were prepared by a central pharmacy and infusion volumes (mL/hour) were identical, thus ensuring double masking.
A total of 1307 patients were randomized (induction, 816; augmentation, 491). In the group receiving oxytocin for induction, high-dose oxytocin was associated with a significant shortening of labor (oxytocin to complete dilatation: 9.7+/-0.3 compared with 7.8+/-0.2 hours, P<.001; oxytocin to delivery: 10.5+/-0.3 compared with 8.5+/-0.3 hours, P<.001). The cesarean delivery rate with low-dose oxytocin was 15.0%, compared with 11.3% with high-dose oxytocin (P = .17). For nulliparous women undergoing induction, cesarean delivery rates were as follows: Total 17.3% (low dose) compared with 11.7% (high dose), P = .15; cephalopelvic disproportion 11.9% (low dose) compared with 5.9% (high dose), P = .06. When used for augmentation, high-dose oxytocin again was associated with a significant shortening of labor without a significant difference in cesarean birth rates. No differences in neonatal outcomes were noted between the groups for either augmentation or induction.
When used in a double-masked fashion, high-dose oxytocin is associated with significantly shorter labors without any demonstrable adverse fetal or neonatal effects.
The rate of labor induction nationwide increased gradually from 9.5% to 19.4% between 1990 and 1998. Reasons for this doubling of inductions relate to widespread availability of cervical ripening agents, pressure from patients, conveniences to physicians, and litigious constraints. The increase in medically indicated inductions was slower than the overall increase, suggesting that induction for marginal or elective reasons has risen more rapidly. Data to support or refute the benefits of marginal or elective inductions are limited. Many trials of inductions for marginal indications are either nonexistent or retrospective with small sample sizes, thereby limiting definitive conclusions. Until prospective clinical trials can better validate reasons for the liberal use of labor induction, it would seem prudent to maintain a cautious approach, especially among nulliparous women. Strategies are proposed for developing evidence-based guidelines to reduce the presumed increase in health care costs, risk of cesarean delivery for nulliparas, and overscheduling in labor and delivery.
The fruits (dates) of the date palm (Phoenix dactylifera L.) contain a high percentage of carbohydrate (total sugars, 44-88%), fat (0.2-0.5%), 15 salts and minerals, protein (2.3-5.6%), vitamins and a high percentage of dietary fibre (6.4-11.5%). The flesh of dates contains 0.2-0.5% oil, whereas the seed contains 7.7-9.7% oil. The weight of the seed is 5.6-14.2% of the date. The fatty acids occur in both flesh and seed as a range of saturated and unsaturated acids, the seeds containing 14 types of fatty acids, but only eight of these fatty acids occur in very low concentration in the flesh. Unsaturated fatty acids include palmitoleic, oleic, linoleic and linolenic acids. The oleic acid content of the seeds varies from 41.1 to 58.8%, which suggests that the seeds of date could be used as a source of oleic acid. There are at least 15 minerals in dates. The percentage of each mineral in dried dates varies from 0.1 to 916 mg/100 g date depending on the type of mineral. In many varieties, potassium can be found at a concentration as high as 0.9% in the flesh while it is as high as 0.5% in some seeds. Other minerals and salts that are found in various proportions include boron, calcium, cobalt, copper, fluorine, iron, magnesium, manganese, potassium, phosphorous, sodium and zinc. Additionally, the seeds contain aluminum, cadmium, chloride, lead and sulphur in various proportions. Dates contain elemental fluorine that is useful in protecting teeth against decay. Selenium, another element believed to help prevent cancer and important in immune function, is also found in dates. The protein in dates contains 23 types of amino acids, some of which are not present in the most popular fruits such as oranges, apples and bananas. Dates contain at least six vitamins including a small amount of vitamin C, and vitamins B(1) thiamine, B(2) riboflavin, nicotinic acid (niacin) and vitamin A. The dietary fibre of 14 varieties of dates has been shown to be as high as 6.4-11.5% depending on variety and degree of ripeness. Dates contain 0.5-3.9% pectin, which may have important health benefits. The world production of dates has increased 2.9 times over 40 years, whereas the world population has doubled. The total world export of dates increased by 1.71% over 40 years. In many ways, dates may be considered as an almost ideal food, providing a wide range of essential nutrients and potential health benefits.
The study documented facility-based obstetric practices for normal labor in Egypt for the first time, to determine their relationship to evidence-based medicine. This paper describes the labor augmentation pattern observed.
176 cases of normal labor were observed by medically-trained observers using a checklist. Ward activities were also documented. Observed women were interviewed postpartum and all findings were shared with the providers for their feedback.
Labor was augmented in 91% (165) of the labors observed; this was inappropriate for 93% or 154 women. Reasons for inappropriateness were: oxytocin ordered at the first vaginal exam (41%); in spite of intact membranes (36%), at the time of membrane rupture (42%), in spite of good progress (24%), or a combination of these. The monitoring of oxytocin-receiving women and their babies was inadequate.
Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.
To compare the efficacy and safety of high dose oxytocin in the augmentation of labor.
Two hundred pregnant women requiring augmentation of labor were randomly assigned to receive oxytocin by either a low dose protocol (1.5 microm/min initially, increased by 1.5 microm/min every 30 min) or a high dose protocol (4.5 microm/min initially, increased by 4.5 microm/min every 30 min).
High dose of oxytocin was associated with a significant shortening of labor 4 (1.10-10) vs. 6 (1-10) h, p<0.0001 without a significant difference in cesarean delivery rate, neonatal and maternal outcome.
The use of high dose oxytocin is associated with significantly shorter labor without any adverse fetal and maternal effects.
Aims:
The aim of this study was to determine during which phase of delivery augmentation is started when used and to establish any correlation that might exist between the oxytocin infusion and the evaluations by primiparas themselves of their labour pain, strength of contractions and fatigue. In addition, we wanted to determine any differences in duration between labour with and labour without augmentation. We finally wanted to measure the incidence of instrumental deliveries, perineal trauma and neonatal outcome among the augmented vs. the non-augmented groups.
Background:
The most commonly diagnosed complication in primiparas is ineffective contractions or protracted labour, otherwise known as dystocia, which literally means arrested or prolonged labour. Different treatments have been tried during the active phase of labour as well as the second stage of labour. The most common treatment today is amniotomy, often used in combination with an intravenous oxytocin infusion.
Materials and methods:
The study was conducted at the hospital in Ostersund in central Sweden from August 1998 to September 1999. Consecutive primiparas giving birth at full-term were selected to the study. The inclusion criteria were an uncomplicated pregnancy and a spontaneous single delivery with head presentation. The total number of participants was 164.
Results:
The results showed that 50 of 164 primiparas needed no augmentation, while 88 were augmented during the active phase and 26 during the second stage of labour. The duration of the active phase [median (md) 4 hours 45 minutes, 6 hours 49 minutes and 6 hours 20 minutes respectively for the different groups, P = 0.03], the time between full dilation of the cervix and the start of the second stage (md 20 minutes, 30 minutes and 60 minutes respectively, P = 0.012) and the duration of the second stage of labour (md 40 minutes, 44 minutes and 60 minutes respectively, P = 0.04) were significantly longer in the augmented groups. Operative deliveries, too, were more frequent in the augmented groups. There was a significantly higher rate of perineotomies in the group augmented during the second stage of labour. There were, however, no differences in Apgar score <7 at 1 minute. pH in the umbilical cord and the base deficit were higher in the group which were augmented during the second stage of labour (P = 0.02 and P = 0.06 respectively). Women describing their impression of the experience as a whole generally gave it a high rating, but women who were augmented during the second stage of labour gave the experience a significantly lower score (P = 0.01).
Conclusion:
Augmentation is used in unusually prolonged deliveries. We did not find that augmentation involved a higher frequency of perineal trauma, although it was correlated with a higher frequency of operative deliveries. There was no correlation between the oxytocin infusion and the primiparas' descriptions of the strength of contractions, pain and fatigue, although greater use of epidurals was observed in women with augmented labour. The number of nulliparas in this study was too small to analyse the incidence of ruptures in the sphincter or draw conclusions about differences between the groups with regard to Apgar scores or metabolic acidosis.
Relevance to clinical practice:
In clinical practice, good routines concerning oxytocin augmentation are crucial. Interventions as oxytocin augmentation seem to cause harm to mother and child. To evaluate interventions continuously in obstetric care is therefore important.
Intrapartum use of oxytocin should entail controlled dosages administered through infusion, continual monitoring of mother and fetus and surgical back-up, since several adverse outcomes have been reported. However, in Uttar Pradesh, north India, small-scale ethnographic studies as well as a large-scale retrospective survey have established that unmonitored intramuscular oxytocin injections are commonly given to birthing mothers to augment labour by unregistered local male practitioners and auxiliary nurse-midwives employed by government during home deliveries. India’s reproductive and child health policy needs to address the inappropriate use of oxytocin. Under a new 2007 policy, female government health workers at peripheral institutions are to be supplied with oxytocin to inject during the third stage of labour to prevent post-partum haemorrhage. The practice of injecting oxytocin intrapartum could readily be reinforced by this policy shift. There is an urgent need to ensure that home births are safer for mothers and babies alike, since India’s current policy goals of raising the numbers of institutional deliveries, ensuring skilled attendance at birth and improving referrals for emergency obstetric care cannot be met in the foreseeable future. In a context of enduringly high infant and maternal mortality, especially in Uttar Pradesh and other large northern states, the question of whether or not inappropriate use of oxytocin is contributing to maternal and newborn morbidity and mortality deserves further research.
Résumé
Pendant l’accouchement, l’ocytocine doit être administrée à doses contrôlées et par perfusion, avec une surveillance permanente de la mère et du fłtus et une assistance chirurgicale, puisque des effets indésirables graves ont été notifiés. Néanmoins, dans l’Uttar Pradesh, en Inde septentrionale, des études ethnographiques à petite échelle et des enquêtes rétrospectives de grande envergure ont montré que des injections intramusculaires non surveillées d’ocytocine sont fréquemment administrées aux femmes pour accélérer le travail par du personnel masculin local non diplômé et des infirmières-sages-femmes auxiliaires employées par l’État pendant les accouchements à domicile. La politique indienne de santé génésique et infantile doit se pencher sur l’administration impropre d’ocytocine. En vertu d’une nouvelle politique de 2007, le personnel de santé féminin employé par l’État dans des institutions périphériques doit recevoir de l’ocytocine à injecter pendant le troisième stade de l’accouchement, pour éviter les hémorragies post-partum. Cette modification pourrait renforcer la pratique de l’injection d’ocytocine pendant l’accouchement. De plus, il est urgent de veiller à ce que les naissances à domicile deviennent plus sûres pour les mères et les bébés, puisque les objectifs actuels de l’Inde qui consistent à relever le nombre de naissances en milieu hospitalier, garantir une assistance qualifiée pendant l’accouchement et améliorer le transfert des urgences obstétricales ne seront pas atteints à brève échéance. Alors que la mortalité maternelle et infantile demeure élevée, particulièrement dans l’Uttar Pradesh et d’autres grands États du nord, la question de savoir si l’utilisation impropre de l’ocytocine contribue ou non à la morbidité et la mortalité de la mère et du nouveau-né mérite davantage de recherches.
Resumen
El uso de oxitocina intraparto debe implicar dosis controladas administradas por infusión, monitoreo continuo de la madre y el feto, y respaldo quirúrgico, dado que se han informado varios resultados adversos. Sin embargo, en Uttar Pradesh, en la India septentrional, los estudios etnográficos de pequeña escala, así como una encuesta retrospectiva de gran escala, han establecido que las inyecciones intramusculares de oxitocina sin monitoreo comúnmente son administradas por prestadores de servicios de sexo masculino no titulados y enfermeras-parteras auxiliares empleadas por el gobierno, durante el parto domiciliario a fin de aumentarlo. La política de la India en cuanto a la salud reproductiva y la salud infantil debe tratar el uso indebido de oxitocina. En conformidad con una nueva política de 2007, las trabajadoras de salud gubernamentales en instituciones secundarias deben ser suministradas con oxitocina para inyectarla durante la tercera etapa del parto a fin de evitar la hemorragia posparto. La práctica de inyectar oxitocina intraparto fácilmente podría ser reforzada por ese cambio en política. Existe una necesidad urgente de garantizar que el parto domiciliario sea seguro tanto para la madre como para el bebé, dado que en el futuro inmediato no es posible lograr los objetivos de la política actual de la India de incrementar el índice de partos institucionales, garantizar asistencia calificada durante el parto y mejorar las referencias para cuidados obstétricos de emergencia. En un contexto de mortalidad materna e infantil perdurablemente altas, especialmente en Uttar Pradesh y otros estados septentrionales importantes, la interrogante en cuanto a si el uso indebido de oxitocina contribuye o no a la morbimortalidad de madres y recién nacidos amerita ser investigada más a fondo.
To answer the question of whether oxytocin induction of labour should be discontinued when active labour begins.
We enrolled patients admitted for induction of labour with oxytocin. Exclusion criteria for induction of labour included non-vertex presentation, past history of more than one caesarean delivery, multiple pregnancies, persistent non-reassuring fetal heart rate before induction of labour and estimated fetal weight of more than 4250 g.
Department of Obstetrics and Gynecology, Ha'Emek Medical Center, Afula, Israel.
Patients who were admitted for induction of labour in Ha'Emek Medical Center from 1st February 1998 to 29th February 2000.
Patients were randomly divided into two groups. In group A, infusion of oxytocin was incremental until 5 cm dilation and maintained at the same level from that point throughout the labour. In group B, infusion of oxytocin was incremental but was discontinued when cervical dilatation reached 5 cm. Comparison between the two groups was made using Wilcoxon rank-sum test and Fisher's exact test.
Primary outcome variable was duration from induction to delivery. The secondary outcome variables included: duration of labour stages, maximal dosage and total amount of oxytocin used, the use of analgesia, abnormalities in fetal heart rate and episodes of uterine hyperstimulation. We also recorded mode of delivery, together with maternal and neonatal outcome.
One hundred and four patients participated in this study. The active phase of labour was shorter in group B compared with group A, but this difference was not statistically significant (2.6 +/- 2 vs 3.3 +/- 2.9, P= 0.07). In group A there were six caesarean deliveries and in group B only three. No significant differences were found when the other outcome parameters were compared.
There is no advantage in continuing oxytocin infusion after the onset of active labour.
Oxytocin is 1 of the most commonly used drugs in labor and has been associated with adverse maternal and fetal outcomes. In an attempt to improve patient safety, we constructed a standardized protocol for labor induction with oxytocin. We reviewed the numerous publications regarding oxytocin use for either induction or augmentation of labor in order to determine if there was a protocol available that would maximize success of delivery and minimize the adverse maternal and fetal effects of the drug. Using the literature review and the specific pharmacokinetics of oxytocin, we developed a standardized approach for the dilution and administration of oxytocin in order to improve patient safety, develop uniformity of the drug use, maximize its benefits, and minimize its side effects. We suggest that a standardized approach to oxytocin use be adopted that uses an oxytocin dilution of 10 mU/mL, initial dose of 2 mU/min (12 mL/hr), incremental increase of 2 mU (12 mL) every 45 minutes until adequate labor with the maximum dose being 16 mU/min (96 mL/hr).
Births: final data for 2002
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Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. 2003. Births: final data for 2002. National Vital Statistics Report 52:1–113.
Births: final data for
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Improving patient safety and uniformity of care by a standardized regimen for the use of oxytocin
- Weinsteinl Hayesej
Comparing the efficacy of dates and oxytocin in the management of postpartum hemorrhage
- Khademn
- Sharaphya
- Latifnejadr
- Hammodn
- Ibrahimzadehs
Randomized, double-masked comparison of oxytocin dosage in induction and augmentation of labor
- Zlatnikfj Merrilldc
Routine oxytocin in the third stage of labour: a placebo-controlled randomised trial
- Nordstroml
Rising rates of labour induction
- Zhangj Rayburnwf
Oxytocics in developing countries
- Boutsenm Dujardinb
- De Schampheleirei
- Kulkerr
- Manshandejp
- Bailyj
Primiparas with or without oxytocin augmentation: a prospective descriptive study
- Nordströml Svärdbyk
- Sellströme