The Impact of Equisetum arvense Vaginal Cream On Premature Rupture of Membranes in Primiparous Women with Striae Gravidarum: A Triple-Blind Randomized Controlled Trial

Background & aim: One of the risk factors of premature rupture of membranes (PROM) is striae gravidarum, which occurs in 50-90% of pregnancies due to poor skin elasticity. It was found that Equisetum arvense is a medicinal plant containing silicic acid, which can increase tissue elasticity, strength and resistance by stimulating collagen synthesis. Therefore, this study examined the effect of Equisetum arvense vaginal cream on PROM in primiparous women with striae gravidarum. Methods: This triple-blind randomized controlled trial was performed on 90 pregnant women with gestational age of 37-38 weeks who had moderate and severe striae gravidarum, referred to the prenatal governmental and private clinics in Mashhad, Iran, between 2020 and 2021. Intervention and placebo groups, who were randomly assigned using quadruple blocks, smeared every night the beginning of the vagina with a knuckle of 3% Equisetum arvense vaginal cream or placebo from the beginning of 37-38 weeks until delivery. The occurrence of PROM was confirmed in case amniotic fluid leaks two hours before the onset of uterine contractions. Data were analyzed using independent t-test and Mann-Whitney. Results: The subjects in the two groups were homogeneous in terms of demographic and obstetric variables. The rate of PROM in the intervention group (13.0%) was significantly lower than the placebo group (38.6%) (p = 0.005). Conclusion: Equisetum arvense vaginal cream is effective in preventing PROM. Therefore, its use is recommended to prevent PROM in women with moderate and severe striae gravidarum.