The Effectiveness of Abdominal BandagingandHotBrickCompression to Level of Fundus in Post – Partum Mothers
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Abstract
Background and Objective: Uterine subinvolution is a condition in which the uterus fails to return to the pelvic cavity within 4 – 6 weeks postpartum. Contributing factors include advanced maternal age, weakened pelvic floor muscles due to improper postpartum self–care, or multiparity. This condition can lead to postpartum hemorrhage and subsequent complications such as pelvic heaviness, back pain, dyspareunia, dysuria, or urinary incontinence. Thai Traditional Medicine (TTM) modalities, specifically abdominal bandaging and hot brick compression, have long been recommended for postpartum care. This study aimed to compare the effects of abdominal bandaging and hot brick compression on uterine fundal height in postpartum mothers.
Methods: The participants consisted of postpartum mothers with normal vaginal deliveries, aged 18 – 45 years, at Song Dao Hospital, Sakon Nakhon Province. Data collection was conducted over a period of one year. A total of 136 participants were selected using purposive sampling based on inclusion and exclusion criteria and subsequently randomized into four groups (n = 34 per group): 1) Control group (standard postpartum care), 2) Abdominal bandaging group, 3) Hot brick compression group, and 4) Experimental group receiving both abdominal bandaging and hot brick compression. Uterine fundal height was measured daily from Day 1 to Day 14 postpartum. The instruments used for data collection included a general information questionnaire and a uterine fundal height recording form. Data was analyzed using descriptive statistics (mean, percentage, and standard deviation) and One–Way ANOVA.
Results: The study revealed that the group receiving combined abdominal bandaging and hot brick compression exhibited a reduction in uterine fundal height until complete involution (returning to the pelvic cavity) by Day 12 postpartum. In contrast, the groups receiving only abdominal bandaging or only hot brick compression achieved complete involution by Day 13 postpartum. Notably, starting from Day 9, a statistically significant difference was observed, with the experimental groups showing a greater reduction in fundal height compared to the control group (p < 0.05).
Discussion: The results demonstrate that postpartum care combining abdominal bandaging with hot brick compression facilitates the most rapid reduction of uterine fundal height (within 12 days) compared to other groups. This finding aligns with Thai traditional medicine principles, which suggest that heat application combined with herbs possessing hot, nauseating, and astringent properties, including Curcuma aromatica Salisb., and Crinum asiaticum L. stimulates blood circulation, reduces inflammation, facilitates lochia discharge and speed up of uterine involution. Concurrently, abdominal bandaging provides mechanical support to firm the abdominal muscles and uterus. The integration of these two interventions creates a synergistic effect, resulting in significantly faster uterine involution compared to single interventions or standard care alone.
Conclusion and recommendations: The combined application of abdominal bandaging and hot brick compression speeds up uterine involution within 12 days, more than only abdominal bandaging and hot brick compression, the recommendation of further study is to compare abdominal bandaging and hot brick compression for uterine involution in primigravida and multigravida and increase the sample size.
Keywords: hot brick compression, abdominal bandaging, postpartum uterine involution
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