Farname Inc. in collaboration with Iranian Society of Gynecology Oncology

Authors

1 Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

2 Reproductive Health Research Center , Department of Obstetrics & Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

3 Guilan University of Medical Sciences, Rasht, Iran

4 Eye Research Center, Department of Eye, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

5 Reproductive Health Research Center, Al-zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran

6 Vice-Chancellorship of Research and Technology, Guilan University of Medical Science, Rasht

Abstract

Background and objective:   Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. The aim of our study was to evaluate the effect of intravaginal magnesium sulfate on pain severity and duration of the first and second stages of labor.
METHODS: In this double-blind randomized clinical trial study, 70 nulliparous women were allocated into two groups after the beginning of the active phase of labor. In the group 1, 10 ccs of magnesium sulfate 50% was poured on the whole cervix during the vaginal examination. In the group 2, a placebo (sterile water) in the similar way and amount was used. Then the two groups were compared in variables of demographic, obstetrics, clinical, pain severity, and duration of the first and second stages of labor, maternal and neonatal outcomes.
RESULTS: In different dilatations, pain severity in the group 1 was significantly lower (p=0.0001). The duration of the first and second stages of labor was shorter in the group 1 (p=0.0001). The two groups were similar in neonatal outcomes, drug side effects, and treatment satisfaction(p>0.05).
CONCLUSION: Intravaginal magnesium sulfate improves the condition of the cervix, reduces the duration and the severity of labor pain, and has no medical or neonatal side effects.

Keywords

  1. 1. Zeng YS, Wang C, Ward KE, Hume AL. Complementary and alternative medicine in hospice and palliative care: a systematic review. J Pain Symptom Manage. 2018;56(5):781–94. 2. Tournaire M, Theau-Yonneau A. Complementary and alternative approaches to pain relief during labor. Evidence-based Complement Altern Med. 2007;4(4):409–17. 3. Mortazavi F, Borzoee F. Fear of Childbirth, Fatigue, and Well-being in Pregnant Women TT -. jogcr [Internet]. 2019 Jun 1;4(2):45–50. Available from: http://jogcr.com/article-1-240-en.html 4. Jenabi E, Khazaei S, Bashirian S, Aghababaei S, Matinnia N. Reasons for elective cesarean section on maternal request: a systematic review. J Matern Neonatal Med. 2020;33(22):3867–72. 5. Mascarenhas VHA, Lima TR, Silva FMD, Negreiros F dos S, Santos JDM, Moura MÁP, et al. Scientific evidence on non-pharmacological methods for relief of labor pain. Acta Paul Enferm. 2019;32:350–7. 6. Blix E, Kaasen A, Eri TS. Labor pain, birth experience and postpartum depression. Scand J Pain. 2020;20(4):859–60. 7. Rotaru LT, Popescu RM, Boeriu C. Plurietiologyc Possibilities and Difficulties of Seizures Management in Pregnancy. Curr Heal Sci J. 2015;41(1):67. 8. Parashi S, Kashanian M, Rabbani O. Comparison between entonox and oxygen on lowering labor pain and the progress of labor. Razi J Med Sci. 2013;20(112):45–52. 9. Sood A, Sood N. Pain Relief in Labor. In: Labour Room Emergencies. Springer; 2020. p. 245–56. 10. Koutsospyros D, Epstein L. Pain in Pregnancy and Labor. In: Academic Pain Medicine. Springer; 2019. p. 305–9. 11. Trout KK. The neuromatrix theory of pain: implications for selected nonpharmacologic methods of pain relief for labor. J Midwifery Womens Health. 2004;49(6):482–8. 12. Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics, 24e. Mcgraw-hill New York, NY, USA; 2014. 13. Whitburn LY, Jones LE, Davey M-A, McDonald S. The nature of labour pain: An updated review of the literature. Women and Birth. 2019;32(1):28–38. 14. Abushaikha L, Oweis A. Labour pain experience and intensity: a Jordanian perspective. Int J Nurs Pract. 2005;11(1):33–8. 15. Shirazi M, Shahbazi F, Akhavan S, Sharifi Taskooh M, Azadi F. Hyoscine-N-Butylbromide and Progression of Labor at Different Stages TT -. jogcr [Internet]. 2016 Dec 1;1(3):0. Available from: http://jogcr.com/article-1-122-en.html 16. Mousa O, Abdelhafez AA, Abdelraheim AR, Yousef AM, Ghaney AA, El Gelany S. Perceptions and practice of labor pain-relief methods among health professionals conducting delivery in minia maternity units in Egypt. Obstet Gynecol Int. 2018;2018. 17. McCauley M, Stewart C, Kebede B. A survey of healthcare providers’ knowledge and attitudes regarding pain relief in labor for women in Ethiopia. BMC Pregnancy Childbirth. 2017;17(1):1–6. 18. Soleimanpour H, Imani F, Dolati S, Soleimanpour M, Shahsavarinia K. Management of pain using magnesium sulphate: A narrative review. Postgrad Med. 2022;(just-accepted). 19. Dupont C, Hébert G. Magnesium sulfate-rich natural mineral waters in the treatment of functional constipation–a review. Nutrients. 2020;12(7):2052. 20. Ikarashi N, Mochiduki T, Takasaki A, Ushiki T, Baba K, Ishii M, et al. A mechanism by which the osmotic laxative magnesium sulphate increases the intestinal aquaporin 3 expression in HT-29 cells. Life Sci. 2011;88(3–4):194–200. 21. Aghamohamadi D, Gol MK. An investigation into the effects of magnesium sulfate on the complications of succinylcholine administration in nulliparous women undergoing elective cesarean section: A double-blind clinical trial. Int J Women’s Heal Reprod Sci. 2019;7(4):520–5. 22. Heydari A, Kariman N, Naeje Z, Ahmadi F. Effect of Topical Application of Magnesium Sulfate on the Intensity of Labor Pain: Double Blind Clinical Trial. Iran J Obstet Gynecol Infertil. 2018;21(5):58–65. 23. Agrawal J, Singh K, Mittal R, Choudhary B. A randomized clinical study to evaluate the effect of intravenous magnesium sulphate for postoperative pain relief in patients undergoing lower segment caesarean section. J Evol Med Dent Sci. 2015;4(72):12478–85. 24. Gupta M, Kumari I, Sharma S, Aggarwal A. Evaluation of the efficacy of MgSO4 as an adjunct to ropivacaine and fentanyl for labour analgesia. J Obstet Anaesth Crit Care. 2020;10(1):10. 25. Mirzamoradi M, Behnam M, Jahed T, Saleh-Gargari S, Bakhtiyari M. Does magnesium sulfate delay the active phase of labor in women with premature rupture of membranes? A randomized controlled trial. Taiwan J Obstet Gynecol. 2014;53(3):309–12. 26. Davoudi M, Tahmasebi R, Zolhavareih SM. Evaluation of the effect of intravenous magnesium sulfate on postoperative pain after cesarean section under spinal anesthesia. Avicenna J Clin Med. 2013;19(4):20–6. 27. Altıparmak B, Çelebi N, Canbay Ö, Toker MK, Kılıçarslan B, Aypar Ü. Effect of magnesium sulfate on anesthesia depth, awareness incidence, and postoperative pain scores in obstetric patients: A double-blind randomized controlled trial. Saudi Med J. 2018;39(6):579. 28. Eldaba AA, Amr YM, Sobhy RA. Effect of wound infiltration with bupivacaine or lower dose bupivacaine/magnesium versus placebo for postoperative analgesia after cesarean section. Anesth essays Res. 2013;7(3):336.