Comparison of the effect of extracts of the date, dill and grape seed versus placebo on postpartum hemorrhage in fourth stage of labor: a double-blind randomized clinical trial

To compare the effect of extracts of the date, dill and grape seed versus placebo on postpartum hemorrhage in fourth stage of labor

This is a double-blind randomized clinical trial, in which 200 eligible patients will be randomly assigned to the intervention and control groups

The eligible pregnant women for normal delivery who will refer to Fatemieh Hospital in Hamadan City during the study period will be enrolled in the trial and will be randomly assigned to the intervention and control groups through the block randomization. This trial will be double-blinded so that neither patients nor the physician who will examine the patients will be aware of the intervention.

Inclusion criteria: Age of 18 to 40 years Normal body mass index, Gestational age between 37 to 41 weeks, Normal childbirth, Second pregnancy without the need for episiotomy, Normal length of the first, second and third stages of delivery, Abnormal bleeding Exclusion criteria: Any complications of pregnancy, Fetal weight between 2500 and 4000 grams, Cephalic presentation, Chronic diseases such as cardiopulmonary, kidney, diabetes, or thalassemia

Intervention group 1: Infusion of oxytocin 300 U in 500 ml Ringer's serum plus lavage with warm water containing 70% date extract Intervention group 2: Infusion of oxytocin 300 U in 500 ml Ringer's serum plus lavage with warm water containing 70% dill extract Intervention group 3: Infusion of oxytocin 300 U in 500 ml Ringer's serum plus lavage with warm water containing 70% grape seed extract Control group: Infusion of oxytocin 300 U in 500 ml Ringer's serum plus lavage with warm water containing placebo

Primary outcome: Hemorrhage in the fourth stage of labor

The patients will be randomly assigned to intervention and control groups using block randomization. For this purpose, we will prepare eight sheets of paper, writing on two sheets the name of the intervention 1, on two other sheets the name of the intervention 2, on two other sheets the name of the intervention 3 and on the third two sheets the name of the control. The paper sheets will be pooled, placed in a container, and randomly drawn one at a time for each patient without replacement until all six sheets are drawn. The eight paper sheets will be then placed back into the container, and this action repeated until the sample size is reached.

The shape of the medications and placebos will be perfectly the same. Therefore, patients will be unaware of the type of intervention. The physician who will examine the patients will not be aware of the intervention. Thus, the trial will be run as triple blind