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Comparison of the effects of dry heat versus moist heat therapy modalities on the intensity of pain and wound healing of episiotomies among postnatal women. A Systematic review and meta-analysis of controlled trials. Six databases searched for original articles using relevant keywords until September 10, 2023, without time or language restrictions. All analyses employed Comprehensive Meta-Analysis (CMA) V.2. The measure of heterogeneity was computed using Cochran's Q-value. The I2 index was employed to quantitatively demonstrate heterogeneity. Statistical significance was reported for P-values <0.05 and I2>50%. Four quasi-experimental and three randomized controlled trials (RCTs) studies with moderate-to-good quality evidence met inclusion criteria. On the third to fifth day after the intervention in the dry heat group, the amount of pain was significantly lower than in the group that used moist heat [MD (95% CI) =-1.395 (-2.374, -0.416), P=0.005]. The use of a hair dryer significantly reduced pain (P=0.029), but an infrared lamp did not significantly reduce pain compared to moist heat (P=0.064). As compared to the moist heat group, the women using dry heat experienced better wound healing to the extent of 2.002 units of the REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) scale, which was statistically significant [MD (95% CI) = -2.002 (-2.785, -1.219), P<0.001]. Compared to sitz baths, dry heat reduced pain and improved episiotomy site healing in postnatal women. Therefore, dry heat, especially hair dryers, is suggested as a non-pharmacological strategy inside maternity hospitals, but additional targeted, high-quality trials are needed. [ABSTRACT FROM AUTHOR]

• Problem or issue. Childbirth usually is painful and frightful for the mother. One of the key goals of safe delivery is to decrease the level of pain, anxiety, and length of labor. • What is already known. Pharmacological and non-pharmacological techniques can reduce labor pain. Increased evidence of pharmaceutical therapies' side effects and risks has led to a shift to non-pharmacological alternatives. Massage can be administered as a means of managing labor pain. • What this paper adds. This systematic review and meta-analysis provide an assessment of the efficacy of sacral massage in labor pain intensity, length of the first labor stage, and for the total duration of labor. The findings showed that, in the sacral massage group, the labor pain intensity was significantly decreased, but does not significantly alter the length of the first labor stage and the total duration of labor. Performing sacral massage during the childbirth process can provide numerous benefits due to its potential to alleviate stress and exhaustion. This systematic review and meta-analysis aimed to assess the effectiveness of sacral massage in pregnant women during labor. A comprehensive search was conducted in main databases from inception to 18th May 2024. The quality of included randomized control trials (RCTs) and quasi-experimental studies was assessed using the Jadad Scale and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS), respectively. All analyses were performed using the RevMan version 5.3. The GRADEpro GDT tool was utilized to determine the level of certainty of the evidence. Nine articles were included in the systematic review and eight studies were included in the meta-analysis. The findings showed that in the sacral massage group, the labor pain intensity was significantly decreased (SMD= -2.40, 95 % CI -3. 5 to -1.29, p < 0.0001 , I² = 97 %). The findings also showed that sacral massage does not significantly alter the length of the first labor stage (MD=-0.04, 95 % CI -0.27 to 0.20, p = 0.77, I² = 0 %) and the total duration of labor (MD= -0.56, 95 % CI -1.66, 0.55, p = 0.32, I² = 90 %). The certainty of evidence for labor pain was moderate and for duration of the first stage and total duration of labor were very low. This study demonstrated that sacral massage was an effective, non-pharmacologic method that significantly alleviating pain in women during childbirth. As a result, this intervention can be implemented in clinical settings during labor. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is a serious complication of pregnancy which increases the morbidity and mortality of both the fetus and pregnant woman. It is characterized by imbalances in angiogenesis, inflammation and endothelial dysfunction which cause the development of hypertension and proteinuria, sometimes progressing into a multisystem disorder. The aim of this systematic review was to analyze all the available data on statins and preeclampsia.Method: MEDLINE/PubMed, OVID, EMBASE, Web of Sciences, and SCOPUS were searched from inception to May 5, 2020. Any study evaluating the effects of statins on women with preeclampsia or HELLP syndrome or who were at risk for it has been included as well as the studies on the placenta of preeclamptic women.Results: 12 articles which included 136 pregnant women and 35 placental samples from hypertensive and normotensive women were analyzed. They showed contradictory effects of statins on blood pressure in preeclampsia, on soluble FMS-like tyrosine kinase-1 (sFlt-1) as well as soluble endoglin (sEng). However, statins caused a significant dose-dependent reduction of sFlt-1 secretion from isolated cytotrophoblasts and an increased secretion of sEng (at least in some studies) in primary HUVECs and placental explants obtained from patients with preeclampsia. Statins also increased eNOS in preeclamptic placentas. Statins were beneficial for patients with antiphospholipid syndrome (APS) preventing preeclampsia and it seems that they might prevent complications of HELLP.Conclusion: It seems that statins might be beneficial for preventing or treating preeclampsia. Nevertheless, further studies are needed to provide definitive conclusions regarding these effects of statins. [ABSTRACT FROM AUTHOR]