جستجوی مقالات مرتبط با کلیدواژه « اپی زیاتومی » در نشریات گروه « پزشکی »

Episiotomy is one of the common methods used to widen the pelvic outlet, and it is associated with complications such as pain and bleeding. Green tea and Myrtus communis are two medicinal plants with anti-inflammatory and pain-relieving properties. The present study was conducted with aim to investigate the effect of Myrtus communis extract and green tea on pain reduction and episiotomy wound healing.

This three-blind randomized clinical trial study was conducted in 2020-2021 on 90 primiparous women referred to the maternity ward of Shushtar Al-Hadi and Ganjovian Dezful hospitals. The samples were randomly treated in groups receiving green tea, Myrtus communis extract ointment and placebo for 14 days. Evaluation of the wound healing status was done with Rida index and pain intensity by VAS. Data analysis was done with SPSS software (version 23) and Mann-Whitney and Friedman tests. P<0.05 was considered statistically significant.

There was a significant difference among the three investigated groups in the Rida index on the 14th day, and this index was lower in the Myrtus communis group than in the green tea group and the placebo group (P=0.001). VAS index on the 14th day had a significant difference among the three investigated groups, and this index was lower in the Myrtus communis group than in the green tea group and the placebo group (P=0.001).

The use of Myrtus communis ointment and green tea extract can reduce pain intensity and improve heal episiotomy wound, and it seems that the effect of Myrtus communis ointment is more than green tea ointment and placebo.

Episiotomy is one of the most common surgeries in midwifery. Episiotomy wound healing can lead to perineal infection and pain, and affects mothers' satisfaction with childbirth. Tea herb with analgesic and anti-inflammatory properties can be effective on mothers' satisfaction with wound healing process. Therefore, the present study was conducted with aim to investigate the effect of tea herb cream on wound healing satisfaction and episiotomy pain intensity in primiparous women.

This double blind randomized clinical trial study was conducted in 2014 on 100 eligible primiparous women referred to Noorani hospital of Talesh. The participants were randomly allocated into two groups: A (drug) and B (placebo). After delivery, the subjects used the creams on episiotomy site twice a day for 10 days. They completed the researcher's questionnaires about satisfaction with treatment on the 10th day after delivery. Data were analyzed by SPSS software (version 19) and Mann-Whitney, independent t test and fisher exact test. P< 0.05 was considered statistically significant.

 The level of satisfaction in the intervention group with mean rating of 73.93 was higher than the control group with mean rating of 25.07. According to the Mann-Whitney test, the relationship between the two groups in terms of the level of satisfaction was significant (P<0.001)

Tea herb cream is effective on the satisfaction of pain improvement and wound healing.

Adopting a safe method to accelerate labor can reduce maternal and fetal mortality and morbidity. Prolonged labor, perineal rupture and episiotomy can be associated with short and long-term maternal and fetal complications. This study was performed aimed to examine the effect of vaginal and perineal massage with duck oil on the length of the second stage of labor, the frequency of episiotomy, and perineal laceration in nulliparous women.

This randomized controlled trial study was performed in 2020 on 129 nulliparous women with singleton pregnancy aged 18-35 years, gestational age 37-42 weeks, and cephalic presentation. The participants were divided into duck oil group (n=43), lubricant gel group (n=43), and control group (n=43). During the second stage of labor, a gentle massage was performed with the index and middle fingers impregnated with duck oil (for the oil group) or lubricant gel (for the gel group). The control group received massage without gel or oil. Data were analyzed by SPSS software (version 23) and Kruskal-Wallis, paired comparison and Chi-square tests. P<0.05 was considered statistically significant.

The mean length of the second stage of labor in the duck oil group (35.77 ±21.47) was significantly lower than the control group (49.65±17.54) and the gel group (44.19±21.35) (P=0.01). There was no significant difference among the groups in terms of perineal rupture and the frequency of episiotomy (p >0.05).

Perineal and vaginal massage using duck oil in the second stage of labor can shorten the length of the second stage of labor, but had no effect on episiotomy and perineal rupture.

Prolonged labor, especially the second stage, negatively affects labor outcomes. Previous studies reported different findings for the effect of lubricants such as oils and gel on vaginal delivery process and outcomes. The Iranian Traditional Medicine recommends massage with oils such as sesame oil to facilitate birth. This study was performed aimed to evaluate the effect of vaginal and perineal massage with sesame oil in comparison with lubricant gel on the duration of the second stage of labor, perineal damage and episiotomy in nulliparous women.

This randomized clinical trial was performed in 2020 on 180 nulliparous women in Ahvaz. The subjects were randomly divided into three groups of sesame oil, lubricant gel, and control group (60 women in each group). In the Sesame oil group, perineal and vaginal massage was performed in the second stage of labor with 5 cc of sesame oil during vaginal examination. The gel group received the same massage with lubricant gel. The control group received only routine care. The duration of the second stage of labor and the frequency of perineal laceration and episiotomy were compared in three groups. Data were analyzed by SPSS (version 22) and covariance and chi-square test. P<0.05 was considered statistically significant.

There were no significant differences among the three groups in terms of demographic characteristics, perineal laceration, and episiotomy (P≥0.05). The duration of the second stage of labor was significantly shorter in the sesame oil group (32.60 ± 1.78 min) than the lubricant gel group (37.50 ±1.78 min) and the control group (44.92 ±78.1 min) (p <0.05).

Vaginal and perineal massage with sesame oil can reduce the duration of the second stage of labor.

The goal of developing midwifery and maternal care is to create a safe delivery and increase maternal satisfaction from birth process. The present study was conducted aimed to evaluate mothers’ satisfaction with transcutaneous electrical nerve stimulation (TENS) in relieving post-episiotomy pain.

This randomized clinical trial was performed on 80 primiparous women referred to Sanandaj Besat Hospital in 2018. Patients were randomly divided into two groups: intervention (TENS-On) and placebo (TENS-Off) groups. TENS electrodes were located in the genitofemoral and pudendal nerves. The satisfaction from TENS was assessed by a researcher-made questionnaire. Data were analyzed using SPSS (version 20.0) and Pearson correlation, Independent t-test, Kruskal-Wallis, variance analysis, and Mann-Whitney tests. P<0.05 was considered statistically significant.

The intervention and placebo groups had a high level of satisfaction. However, the mean satisfaction in the intervention group (17.35±1.96) was significantly higher than the placebo group (13.45±2.02) (p<0.001). There was no significant relationship between demographic variable and satisfaction level (p˃0.05).

TENS can have a noticeable effect on the level of maternal satisfaction. Therefore, it is suggested to implement TENS to reduce post-episiotomy pain in all maternity units in order to increase the level of satisfaction of patients and improve the level of mental health of mothers.

One of the medical interventions in childbirth is episiotomy which is used to widen the pelvic outlet. Plantago is one of the oldest medicinal plants that have wound healing properties due to its flavonoids and phenolic compounds. The present study was performed aimed to determine the effect of plantago cream on intensity of pain and episiotomy wound healing in nulliparous women.

This triple-blind clinical trial study was performed in 2019 on 107 nulliparous women who had referred to Valiasr Hospital in Birjand for natural childbirth. The participants were randomly divided into two groups of placebo and drug. After delivery, mothers used 2-3 cm of prescribed cream on the sutures for 10 days and twice a day. The wound healing rate was evaluated on the third, seventh and tenth days after delivery using the Reda tool. Data were analyzed using SPSS 21 software and Chi-square and Mann-Whitney tests. P< 0.05 was considered statistically significant.

The mean of Reda score in the drug group was 3.433 ± 0.635 on the third day, and 0.773 ± 0.422 on the seventh day, but in the placebo group, it was 5.611 ± 0.492, 2.185 0 0.478, respectively. The two groups had significant difference on the third and seventh days in terms of wound healing (p<0.001).  The median McGill score in the drug group was 26 on the third day and 7 on the seventh day, but in the placebo group, it was 44 and 19, respectively, and the two groups had a statistically significant difference in terms of pain intensity on the third and seventh day (P<0.001)

The use of plantago cream in comparison with placebo increases the speed of improvement of pain intensity and episiotomy wound healing in nulliparous women.

 Episiotomy is the most common surgery in midwifery that like any other wound, can cause infection or delayed healing. Olive oil and honey have antimicrobial and wound healing properties, so the present study was performed aimed to compare the effect of honey and olive oil on the rate of episiotomy in postpartum women.

This double-blind randomized clinical trial study was performed on 165 postpartum women in Besat Hospital of Sanandaj in 2019. Samples were randomly assigned to three groups: olive oil cream, honey cream and placebo cream. To collect data, a questionnaire of demographic and midwifery characteristics and the form of complications caused by creams and Reeda wound healing scale were used. The intervention was performed as using honey cream, olive oil cream and placebo cream every 12 hours for 10 days at the episiotomy site. Evaluation of Rida index was performed in the first 12 hours after delivery, before the intervention and on the 5th and 10th days after delivery. Data were analyzed by SPSS software (version 21) and analysis of variance, univariate covariance, Chi-square, and Post-Hoc. P <0.05 was considered statistically significant.

Demographic and obstetric characteristics were the same in the three groups (p> 0.05). The mean of Reeda index on the 5th and 10th day after delivery had significant difference among the three groups (P<0.05) and decrease of Reeda index in the honey group was more than olive oil (P = 0.008).

The use of honey cream to repair episiotomy reduces infection and accelerates wound healing.

The second stage of labor is a sensitive period for the mother and the fetus. In different studies, various delivery techniques have been used to manage the second stage of labor. This study aimed to investigate the effect of management methods of the second stage of labor on the incidence of maternal and neonatal complications in nulliparous women.

This single-blind semi -experimental study was performed on 60 women with the required qualification for this research in Mobini Hospital in Sabzevar. Individuals were divided into two groups based on the mother's desire. In the active pushing group, at the onset of contractions, the mother breathes deeply and then holds the breath and pushes for ten seconds. On the other hand, in the Spontaneous pushing group, the mother does not actively try to push in the onset of contraction (unless the pressure and force is involuntarily created). Then, the mothers were taken to the delivery bed, after delivery, information about labor, delivery, perineal status, and infant information was recorded. Data were analyzed with SPSS software, t-tests, and chi-square.

In the Spontaneous pushing group, the rate of instrumental delivery, duration of the second stage of labor, perineal rupture, abnormal fetal heart rate at the second stage (p<0/05) were significantly less and the amount of healthy perineum (p<0.01) and delivery experience score (p<0.001) were higher.

The Spontaneous pushing method reduces the chances of fetal abnormal heart rate, instrumental delivery, perineal injury, and duration of the second stage of labor and increases labor satisfaction. Therefore, it is recommended that this method be used in the second stage of labor.

Limited use of episiotomy and performing selective episiotomy versus conventional episiotomy has been recommended in various studies. But according to the statistics from developing countries, episiotomy is still the most common obstetric incision. The most common cause of episiotomy in low-risk mothers is maternal concern about severe perineal injuries. This study was performed with aim to compare perineal injuries in normal delivery of primiparous mothers with and without episiotomy.

This descriptive-analytical study was performed by reviewing 3602 files of primiparous pregnant women who had a normal delivery in Sabzevar Obstetrics and Gynecology Hospital during 2017 and 2019. Data collection tool was a researcher-made checklist. The maternal demographic variables, active phase length, neonatal weight, neonatal head circumference, labor mobility, induction or non-induction with oxytocin, and exposure to analgesia, neonatal hospitalization in neonatal intensive care unit (NICU), neonatal death and the degree of perineal damage including grade 1, 2, 3 and 4 laceration. Data were analyzed by SPSS software (version 21) and Chi-square and regression tests. P<0.05 was considered statistically significant.

In the delivery group without episiotomy, 317 mothers (37.8%) had healthy perineum, 324 (38.5%) grade 1 laceration and 56 (6.6%) grade 2 laceration, but in the delivery group with episiotomy, 1302 (99.3%) had grade 2laceration. Chi-square test showed a significant difference between the two groups in terms of perineal injuries (P= 0.0001). The rate of severe perineal injuries was not significantly different in the delivery group with and without episiotomy (p> 0.05). The NICU admission was not significantly different between the two groups (p> 0.05).
 

Delivery without episiotomy in primiparous mothers who don't have risk factors for maternal diabetes, instrumental delivery and infant weight > 4000 g, does not increase severe perineal injuries.

Episiotomy is one of the causes that can affect mothers' postpartum quality of life. Aloe Vera plant has been suggested as one of the ways to heal wounds and reduce pain. Regarding to these properties, several clinical trial studies have been conducted to determine the effect of aloe vera on episiotomy pain relief and wound healing, and different findings have been reported. This study was performed with aim to determine the effect of Aloe Vera on episiotomy pain relief and wound healing.

In this systematic review study, the databases of Scopus, PubMed (MEDLINE), Embase, Proquest, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Library and Web of Science were searched using the keywords of "pain", "Wound", "Healing", "Episiotomy", " Perineum" and "Aleo Vera" by OR and AND without time, language and geographical limitation until 23 April 2021. The quality of the articles was evaluated using the Cochran Group tool and data were analyzed by Stata software (version 14). Cochran test and I2 index were used to assess the heterogeneity of the articles.

Finally, 9 articles with sample size of 611 people were included in this systematic review study. Preliminary studies showed the effectiveness of Aloe Vera in wound healing and pain relief. Four studies with sample size of 258 patients had the potential to perform the meta-analysis for pain outcome. Results of the meta-analysis showed that Aloe vera can reduce pain intensity compared to the control group (P<0.05).

Aloe Vera seems to be effective in repairing episiotomy wounds and reducing pain; however, high quality studies with sufficient sample size are recommended for definitive results.

Routine use of episiotomy is not recommended for women giving birth naturally. However, several studies in the Middle East have reported that it has high prevalence, but there is no general estimate. This study was performed with aim to review the prevalence and met-analysis of episiotomy in the Middle East based on studies conducted in this field.

To search for articles, the databases of SID, Magiran, Medline, Science Direct, Scopus, Web of Science, Embase, ProQuest and google scholer search engines using the keywords of prevalence, epidemiology, frequency, incidence, rate and episiotomy in both languages of Persian and English and all possible combinations were searched with AND and OR operators. Calculation of heterogeneity of the studies was evaluated using I2 index and Bag test was used to examine the bias.

Twelve articles with a sample size of 69171 were reviewed. The overall prevalence of episiotomy was 67% (95% CI: 55-78). Using the random effect model, the risk of episiotomy in primiparous women was two times than multiparous women, which was statistically significant (RR = 2.01, 95% CI: 0.87-4.63, p <0.001; I2 = 99.99). Oxytocin use was also associated with an 80% (60-95%) prevalence of episiotomy.

Due to the high rate of episiotomy in the Middle East, despite the standard set by the World Health Organization, there is an urgent need for planning to reduce this rate. Therefore, it is recommended to use effective methods to reduce the need for episiotomy in primiparous women and to avoid unnecessary clinical interventions such as using oxytocin.

Episiotomy is the most common incision in midwifery to increase the diameter of pelvic outlet. Anzaroot contain flavonoid, saponin, tryptophanes, tannins and other polyphenolic compounds. So it has analgesic properties. This study was performed with aim to determine the effect of Astragalus fasciculifolius (Anzaroot) gel on episiotomy pain severity in primiparous mothers.

This three-blind clinical trial study was conducted on 72 primiparous women referred to Shahid beheshti hospital in Isfahan in 2019. They were randomly divided into two equal groups of experiment (Anzaroot) and control (Placebo gel). Severity of pain was assessed using the visual pain scale (VAS). Data were analyzed by SPSS software (version 16) and Independent Samples T Test, covariance analysis and repeated Measures analysis. P˂0.05 was considered statistically significant.

There was no significant difference between two groups in demographic features and obstetric variables (P˃0.05). Before the intervention, no significant difference was observed between two groups in the severity of pain (P=0.16(. After the intervention, severity of pain in the experiment group was significantly less than the control group (p < 0.05).

Anzaroot gel is more effective than placebo in relieving of episiotomy pain.

Episiotomy is the most common surgery in obstetrics that like any other wound can cause infection or delay in wound healing. Hypericum perforatum has antimicrobial and anti-inflammatory and wound healing properties. Therefore, this study was performed with aim to determine the effects of Hypericum perforatum on episiotomy wound healing in primiparous women.
This double blind randomized clinical trial was performed on 100 eligible women referred to Shahid Noorani hospital of Talesh in 2014. The subjects were randomly allocated into two groups of Hypericum cream (group A) and placebo (group B). After delivery, two groups used 2 cm Hypericum or placebo cream at scar site twice a day for 10 days. Wound healing was measured before the intervention, first 12 hours and 5 and 10 days after delivery by RIDDA scale. Data were analyzed by SPSS software (version 19) and Mann-Whitney and independent t test. P<0.05 was considered statistically significant
The mean of wound healing score before the intervention was not significant in two groups (p>0.05). The mean of RIDDA score significantly decreased at 12 hours and 5 days and 10 days after delivery in hypericum perforatum cream group (p<0.05).
Hypericum perforatum cream is effective on perineal wound healing.

Delay in episiotomy wound healing is associated with an increased risk of infection; prevention of perineal wound infection is a major component of daily care for mothers. For more quickly healing of episiotomy wounds, low cost, effective, convenient, accessible and acceptable methods are considered by women; medicinal plants are of these methods. Therefore, this systematic review was performed with aim to investigate the effects of medicinal plants on the episiotomy wound healing in Iran.

Electronic search was done in databases of Iranmedex, Magiran, SID, Web of Science, Science Direct, Scopus, Pubmed, as well as Google Scholar search engine with Persian and English keywords including: Episiotomy, Wound healing, Perineum, Herbal Medicine, and Medicinal Plants. Combined searches of the keywords was performed using OR and boolean AND operators. The search period was from observation to December 2019. According to the CONSORT 2010 checklist, the studies with a score of ≥18 were included in the study. Data analysis was performed qualitatively.

In this study, 28 clinical trials including 19 types of medicinal plants were studied. According to the results of the studies, most plants were effective in episiotomy wound healing.

Plants such as as Aloe Vera, Turmeric and Lavender that have anti-inflammatory, antibacterial and antioxidant properties are desirable options for wound healing. Due to insufficient number of articles in some cases and inconsistency in the results of some other articles, we can't definitively comment about these plants. Therefore, for definitive effectiveness of these interventions, further studies with larger sample size are recommended.

One of the surgical interventions in the process of natural vaginal delivery is episiotomy. Episiotomy pain is a stressful problem for mothers at postpartum. Nowadays, more attention has been paid to the use of pain reduction techniques in traditional medicine such as clove extract. Therefore, this study was performed with aim to evaluate the effect of hydroalcoholic extract of clove buds on the severity of episiotomy pain in normal vaginal delivery.

This triple-blind clinical trial study was performed on 80 mothers who had delivery in the hospitals of Ferdows, Gonabad and Mashhad in 2019. The subjects were divided into two groups of intervention and placebo using randomized blockade. The intervention group received clove extract and the placebo group received distilled water. The two groups received the solutions twice a day for 10 days after delivery. Demographic and midwifery checklists and pain visual standardized tool and McGill tool were used for data collection. Pain severity was measured in several stages (before intervention, on day 4 and day 10 after delivery). Data were analyzed by SPSS software (version 22) and paired t and Chi-square tests. P < 0.05 was considered statistically significant.

There was no statistically significant difference in pain severity between the two groups before the intervention (p = 0.77). There was significant difference in pain severity between the two groups at day 4 (p = 0.00) and 10 (p = 0.00) after delivery.

The use of clove extract reduces the severity of episiotomy ulcer pain after delivery. Therefore, it is recommended to use it for pain relief after episiotomy.

Kegel exercises can improve episiotomy and increase women's satisfaction with vaginal delivery by increasing muscle strength and muscle fitness. The aim of this study was to investigate the effect of Kegel exercise on episiotomy in primiparous women referred to Fatemieh Hospital in Hamadan in 2018.

The present study is a clinical trial and was performed on 100 pregnant women referred to Fatemieh Maternity Hospital in Hamadan in 2018. Subjects were divided into experimental and control groups. Kegel Exercise Training was performed for the experimental group. Theoretical and group training was conducted in groups of 6 and one session each. Follow-up was done by telephone and attending physiological delivery sessions. The control group received no training and at the end of the study the frequency of episiotomy was evaluated in both groups. Data were analyzed using SPSS 21 and descriptive statistics. They were analyzed analytically.

The mean age of the experimental and control groups was 25.94 ± 3.35 and 26.36 ± 4.89, respectively. The two groups were homogeneous in terms of age, occupation, educational level, exercise, type of contraceptive method. In the experimental group 62% and in the control group 94% episiotomy was performed. According to the results, the episiotomy rate was 9.60 times lower in people who did not use the Kegel exercise.

The present study showed that Kegel exercise can enhance pelvic floor muscles and, by increasing endurance of these muscles, increasing pelvic perfusion and muscle relaxation, facilitates labor and reduces the need for episiotomy and reduces pain. Finds.

Episiotomy is of common surgical procedures in midwifery and is followed by complications including inflammation, edema, approximation of the wound and perineal pain. In past, Myrtus communis plant has been used to treat wounds and relieve pain. This study was performed with aim to investigate the effect of M. communis cream on wound healing and episiotomy pain severity.

This double-blind clinical trial was conducted on 100 nulliparous women in Zabol Amiralmomenin Ali Hospital from July to November 2018. The participants randomly received Myrtus Communis cream or placebo and used the encoded creams 2 times a day for 10 days. Demographic and obstetrics questionnaire, health status form, analgesic used, Numeric pain rating scale, Reeda scale and drug side effects table were used to assess the individuals. Then, the pain severity and recovery rate were examined on the first 2 hours, fifth and tenth day after delivery. Data were analyzed by SPSS software (version 23) and Mann-Whitney, independent-t, and Chi-square tests. P<0.05 was considered statistically significant.

There was no significant difference between two groups in terms of demographic and obstetric variables and pain severity in first 2 hours after delivery (p>0.05). The mean difference of pain severity on the fifth (p=0.009) and tenth day (p=0.012) after delivery was significant in M. communis cream and placebo cream groups, and the severity of pain was less pain in M. communis cream group. The mean of Reeda score group on the 5th day after delivery was 1.70 ± 1.09 in the M. communis cream group and 2.94 ± 1.51 in the placebo cream group (p<0.001), and on the tenth day after delivery was 1.04 ± 0.854 in the M. communis cream group and 2.06 ± 0.620 in the placebo cream group that was statistically significant (p<0.001).

M. communis cream due to its healing properties accelerates the healing of episiotomy wound and reduces the severity of pain.

Episiotomy is one of the common surgeries in midwifery that despite its small size may cause complications such as inflammation, infection or pain like any other wound. Frankincense due to anti-inflammatory effects is used in many cases, including pain relief and wound healing. This study was performed with aim to evaluate the effect of Frankincense ointment on pain intensity and episiotomy wound healing in primiparous women.
This experimental and three-blinded-study was performed on 95 primiparous women with vaginal delivery and mid lateral episiotomy in Mahdieh hospital of Tehran in 2017-2018. The subjects were divided into two groups of Frankincense ointment (intervention group) and placebo (control group). Demographic and obstetric questionnaire, health status forms, pain scale (VAS), perineal evaluation Index (REEDA) and drug complications questionnaire were used to evaluate the subjects. The ointments were used every 12 hours and for 10 days from the first day after delivery. Evaluation of pain intensity, perineal repair and drug complications were performed on days 1,5, and 10 after delivery. Data were analyzed using SPSS software (version 21) and Mann-Whitney, Chi-square and Fischer tests. P<0.05 was considered statistically significant.
 On the first day after birth, no significant differences were observed between two groups in terms of mean score of REEDA (P=0.752) and pain intensity (P=0.50). The mean score of REEDA in the intervention group on fifth and tenth days were 2± 1.62 and 0.95 ± 0.99, respectively, and in the control group were 4.04 ± 2.38 and 2.52 ± 2.05, respectively; these differences were significant (P=0.026, P<0.001). The mean of pain intensity on the fifth and tenth days in the intervention group were 2 ± 1.23 and 0.95 ± 0.50, respectively, and in the control group were 3.16± 1.57 and 1.97 ± 1.17, respectively. In both groups these differences were statistically significant (P=0.030, P<0.001).
Frankincense ointment with anti-inflammatory properties is effective in the episiotomy wound healing and pain reduction.

  Episiotomy is one of the most common surgical procedures in women. The pain caused by episiotomy is always stressful and has negative effects on women's functions. The aim of this study was to assess the effect of Aloe Vera gel on perineal pain and wound healing after episiotomy among primiparous women. This study was a randomized double-blinded controlled clinical trial was conducted on 80 women referred to Tamin Ejtemaee Hospital, Hamadan, Iran, in 2017. The participants were divided into the intervention (Aloe Vera gel, n=40) and control (normal saline, n=40) groups. The REEDA questionnaire, and Visual Analog Scale were used before and 3,7,10 days after the intervention.
The data were analyzed in SPSS software (version 21) through the Chi-square test, duplicate measurement, and independent and paired samples t-tests. The results showed no significant differences between the two groups in terms of the mean scores of episiotomy pain and wound healing before the intervention (P<0.05). However, there was a significant difference between the two groups based on independent t-test after intervention (P<0.001). The results showed that Aloe Vera gel reduced pain and healed episiotomy ulcer, compared to the normal saline. The use of Aloe Vera gel, compared to normal saline, reduces pain and accelerates episiotomy ulcer healing with no side effects; therefore, it can be beneficial for women

Introduction: Episiotomy is one of the most important causes of postpartum pain, limiting the mothers' movement and ability to care the infant. This study aimed to investigate the effect of Chamomile-Marigold ointment on episiotomy pain in nulliparous women.

This single-blind randomized clinical trial was conducted on 99 eligible women who referred to Shahid Akbarabadi Hospital in Tehran. After obtaining written informed consents, the participants were randomly assigned to intervention, placebo and control groups. 4 hours after delivery, the participants in the intervention group had to rub the ointment (in the size of knuckle) on the stitches and repeat it every 8 hours for ten days. The severity of episiotomy pain was evaluated before the intervention and on the 1st, 5th and 10th days after delivery using a 10-point Visual Analogue Scale (VAS). The data were analysed using Chi-square, ANOVA and Kruskal-Wallis tests at significance level of <0.05.

There was no statistically significant difference among the three groups before the intervention (p-value = 0.108). The mean pain intensity in the first, fifth and tenth days after delivery in the intervention group was 3.24 ± 1.20, 2.33 ± 1.65 and 1.33 ± 2.65, respectively, which was significantly lower than those in the two other groups (P-value =0.001).

Given its anti-inflammatory effects, Chamomile-Marigold ointment can be used to relieve episiotomy pain and patients’ need for analgesics.