A systematic literature search was conducted, and articles published between January 2012, to December 2022 were included in this scoping review. This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines used to guide this review (Page et al. 2021). The PICOS items, i.e., population, intervention, comparator, outcomes, and study design following the previous scoping review (Kusuma et al. 2022). All curated studies were then imported into Zotero software to identify and remove duplicate records.

Three databases (PubMed, Scopus, and Web of Science (WoS)) were searched for articles containing the keywords “preeclampsia” AND “complementary treatment,” and the results were compiled. Articles written in languages other than English and abstracts that were never expanded upon were not considered.

Studies documenting the application of complementary and alternative care for postpartum PE were included. The inclusion criteria such as case study, randomized clinical trial, preeclampsia, post natal preeclampsia, and conference proceeding. On the other hand, review study, animal study, commentary, editorials, books, newspaper, non-open access, non English article were excluded.

Four independent reviewers (SR, ST, TRA, and SM) screened the titles and abstracts of all identified articles for eligibility using the predefined inclusion and exclusion criteria using Rayyan AI software (Ouzzani et al. 2016). The data extraction screening included information on study design, participant characteristics, intervention details, outcomes, and limitations. Any disagreements were resolved through discussion and consensus. The full text of potentially eligible articles was then reviewed by the same four reviewers (SR, ST, TRA, and SM) using the same criteria. A third round of screening was also conducted to identify additional studies that met the inclusion criteria based on the full text review of the reference lists. Two reviewers (SR and TRA) separately extracted data, then cross-checked and compiled it by SR. The synthesis involved a descriptive summary of the study characteristics and a thematic analysis of the reported outcomes in Microsoft Office Excel 2019 using a standardized template. The data included the author, year, country, title, study design, population/participants, intervention, duration of intervention, durations of intervention, participants and outcome provided (see Table 1).

Seven papers were located that addressed the use of nonconventional treatments for preeclampsia, some of which might be used in the postpartum period as well In light of Egypt (Awad et al. 2019), China (Wang et al. 2021), United States of America (Gardiner et al. 2013), Iran (Jahdi et al. 2016; Kianpour et al. 2016) and Indonesia (Nikmah and Machmudah 2019; Zainiyah et al. 2019), in the treatment of preeclampsia following delivery, each of these options varies in certain ways while also sharing some commonalities (see Table 1).

Evidence suggests that a model for ensuring the continued use of newly acquired skills can be found in the results of a study conducted in Brazil by Lima et al. 2018, which examined the impact of an action-oriented educational intervention on the knowledge, attitudes, and practices (KAP) of community health workers (CHWs) in maternal and infant health(Lima et al. 2018). The intervention group participated in a 4-day interactive training course (Pallivalappila et al. 2013). Studies have shown that women are more likely to see massage therapists (34.1%), chiropractors (16.3%), and yoga/meditation courses (13.6%) than acupuncturists (9.5%), naturopaths/herbalists (7.2%), or osteopaths (6.2%) (Steel et al. 2012). The following studies are examples of complementary treatments that have been demonstrated to be utilized to enhance the care that is provided to postpartum women who are diagnosed with preeclampsia:

Traditional Chinese Medicine (TCM) is gaining popularity among pregnant women in Taiwan as a method of therapy for issues such as pregnancy-induced hypertension and morning sickness. TCM was developed in China. It is still not entirely understood whether or not preeclampsia may be effectively treated with traditional Chinese medicine (Rasouli et al. 2019). A study by Wang found that treating severe preeclampsia with a combination of Traditional Chinese Medicine (TCM) and Western medicine is more effective than using Western medicine alone. The treatment improved the levels of antioxidants in the body (SOD: superoxide dismutase; GSH-Px: Glutathione peroxidase), reduced oxidative stress injury (MDA: malondialdehyde; LPO: lipid peroxides; AOPP: advanced oxidation protein products), decrease blood pressure, IL-6 (interleukin-6), TNF-α (tumor necrosing factor-α), CRP (C-reactive protein), and Hcy (homocysteine) levels. According to the findings, using a combination strategy like this to treat severe preeclampsia appears to have a beneficial effect on the outcomes for both the mother and the baby (Wang et al. 2017). As a result, the utilization of this treatment approach has the potential to lessen the number of unfavorable pregnancy outcomes that occur following a cesarean section that is performed under combined lumbar and epidural anesthesia (Wang et al. 2021).

The term “massage therapy” (often abbreviated as “MT”) refers to the systematic and intentional manipulation of soft tissue for therapeutic reasons (Ooi et al. 2018). Researchers Jahdi and colleagues found that nulliparous women experienced less anxiety on the first postpartum day after receiving a slow-stroke back massage. This intervention was shown to be effective, simple, affordable, and noninvasive. As all pregnant women in Sabzevar are sent to the one obstetric and gynecologic center (the Mobini hospital), the results may be generalized to all women in the city (Jahdi et al. 2016).

Aromatherapy is one of the CAM (complementary and alternative medicine) subfields that is experiencing the most rapid expansion. “the therapeutic use of scents or at least of simple volatiles to treat or to ameliorate or to prevent sickness, infections, and indispositions exclusively by means of inhalation” is one definition of aromatherapy (Yelfi et al. 2019). Nipple fissures, episiotomy, cesarean section birth, sleep, mood, tension, anxiety, distress, and depression were all positively affected by aromatherapy, as reported in a systematic study conducted by Shuo-Shin (Shuo-Shin et al. 2020).

Soaking the feet (foot hydrotherapy) in warm salt water for 15 minutes twice a day for three days has been shown to reduce swelling in postpartum preeclampsia. As a form of detoxification, this treatment helps the body eliminate toxins by increasing blood flow and oxygen delivery to the swollen tissue through the dilation of blood vessels (Sulfianti et al. 2021). Because of the physiological effects of warm water, this treatment was proven to be successful in lowering edema in pregnant women by Zainiyah et al. 2019, warm water enhances tissue metabolism and permeability and lessens muscular tension by relaxing the muscles and dilating blood vessels. Blood will pool in the heart’s arteries due to the hydrostatic pressure of water, which causes the veins and arteries to swell from the legs to the chest. Preeclampsia patients may find warm foot therapy to be a practical choice because of its ease of use, low cost, and lack of risk (Zainiyah et al. 2019).

After birth, the mother’s body goes back to its pre-pregnancy state physiologically and anatomically. The postpartum period, sometimes called the puerperium, extends from the time of placental evacuation until the time when all of the newborn’s physiological systems have fully recovered (Brown et al. 1999; Romano et al. 2010). Within the first 24 hours, the body temperature returns to normal, albeit it may rise to as high as 37.2 °C (99 °F) and cause increased shivering, sweating, or diaphoresis (Bystrova et al. 2007; Benson et al. 2008). The accumulation of metabolites from muscular contractions is what causes the temperature to rise when they are absorbed into the circulatory system. On the third or fourth day, breast engorgement may cause a temporary temperature increase (by 0.5 °C). Throughout the first few days after giving birth, the breathing rate also starts to return to its normal, lower, pre-pregnancy level. A third-day or greater fever increase is indicative of infection (Alekseev et al. 2015; Woodd et al. 2019; Boushra and Rahman 2020). Expulsion of the placenta and the resulting blood loss causes a loss of between 5 and 6 kg of weight. The rapid diuresis also contributed to the additional 2–3 kg of weight loss. Diuresis-induced weight loss can last for up to six months after giving birth (Lambrinou et al. 2019). Involution also refers to other alterations in postpartum physiology. Reproductive organs undergo a process called involution in which they revert to their condition before to conception. The placenta and uterus quickly contract after birth to stop any more bleeding (Ucci et al. 2021).

Colostrum is an early form of breast milk that mothers produce in greater quantities in the postoperative period (Silberstein et al. 2019). It varies from woman to woman whether or not she is nursing when her first period begins after giving birth. Menstruation often resumes between the sixth and eighth week postpartum if the woman is not nursing (Crowley 2017). There may be little urgency to urinate, leading to swelling and hyperemia of the bladder wall and possible overdistention (Chauhan and Tadi 2020). It is estimated that between six and eight liters of total body water are transferred from the extravascular region to the intravascular region. The continuous stimulation of the renin-angiotensin-aldosterone system (RAAS) that occurs during pregnancy results in an increase of 950 mEq in the amount of sodium that is found in the body (Ogueh et al. 2011; Reddy and Jim 2019). Moreover, the woman may experience hemorrhoids, laxity of the abdominal wall, and loss of bodily fluids (Shin et al. 2015). About nine in ten pregnant women have some degree of hyperpigmentation (Bieber et al. 2017).

Women with preexisting hypertensive diseases are more likely to experience postpartum hypertension, however hypertension can also arise in this population (Hoyert and Miniño 2020). Women who develop hypertension for the first time between 48 hours and 6 weeks after giving birth may have postpartum preeclampsia, a diagnosis that may or may not be made, depending on the terminology used. There are few evidence-based guidelines for the diagnosis and therapy of new-onset postpartum preeclampsia due to a lack of research into this disease type (Sibai 2012; Hauspurg and Jeyabalan 2022)preeclampsia, or preexisting chronic hypertension, or it could develop de novo postpartum secondary to other causes. There are limited data describing the etiology, differential diagnosis, and management of postpartum hypertension-preeclampsia. The differential diagnosis is extensive, and varies from benign (mild gestational or essential hypertension. We did, however, identify postpartum preeclampsia with a delayed start. Neurologic symptoms, most often headache, are the first to be seen in the majority of women with delayed-onset postpartum preeclampsia within the first 7–10 days following birth (Sibai 2012; Hauspurg and Jeyabalan 2022) preeclampsia, or preexisting chronic hypertension, or it could develop de novo postpartum secondary to other causes. There are limited data describing the etiology, differential diagnosis, and management of postpartum hypertension-preeclampsia. The differential diagnosis is extensive, and varies from benign (mild gestational or essential hypertension. Despite the fact that postpartum preeclampsia is associated with a greater risk of maternal morbidity than preeclampsia with antepartum start, it is still a poorly understood disease process (Hauspurg and Jeyabalan 2022).

The results depict that herbal ingredients are effective in treating preeclampsia after childbirth (Gardiner et al. 2013; Wang et al. 2021). Wang et al. 2021, provided a more in-depth analysis of the variance between the experimental and control groups’ overall clinical successful rates of therapy utilizing herbal medicine, which were 90.36 and 71.08%, respectively (Wang et al. 2021). Iranian researchers Kianpour et al. 2016, found that preeclampsia risk factors such maternal stress, anxiety, and postpartum depression can be mitigated by the use of lavender aromatherapy. Based on the results of the study, aromatherapy with lavender can help reduce anxiety during delivery by decreasing cortisol levels and raising serotonin release (Kianpour et al. 2016).

Reduce edema in the legs by soaking your feet in warm water with salt for 15 minutes each morning and night for three days. This is especially helpful for postpartum mothers who have developed preeclampsia. The average measurement of edema before and after the intervention was 16.33 and 12.27, respectively, demonstrating that this approach increases blood flow and lowers swelling (Zainiyah et al. 2019). Nikmah and Machmudah conducted a research on the effects of magnesium sulfate (MgSO4) treatment and slow-stroke back massage (SSBM) on the blood pressure of women with severe preeclampsia. Systolic and diastolic blood pressure were both shown to fall following therapy in this research. Before and after treatment with MgSO4 and MgSO4+SSBM, the systolic blood pressure readings were 168.63 mm Hg and 153.75 mm Hg, and 151.94 mm Hg and 141.87 mm Hg, respectively. Before and after treatment with MgSO4 and MgSO4+SSBM, diastolic blood pressure was 104.44 mm Hg and 91.88 mm Hg, and 94.81 mm Hg and 87.00 mm Hg, respectively (Nikmah and Machmudah 2019).

Physical therapy, including stretching exercises, autogenic training, and slow-stroke back massage, has been shown to lower blood pressure in postpartum women in studies conducted by Awad in Egypt and Jahdi in Iran (Jahdi et al. 2016; Awad et al. 2019). Group A consisted of 20 women who did stretching exercises, while Group B consisted of 20 women who did autogenic training for relaxing (AT). Systolic blood pressure was 13.75% lower in group B compared to group A, and diastolic blood pressure was 12.88% lower compared to group B, and proteinuria was 19.50% higher in group B compared to group 17% higher in group A (Awad et al. 2019). While exercise boosts parasympathetic activity, which in turn causes bradycardia, it has the potential to significantly reduce preeclampsia risk by reducing both blood pressure and resting heart rate (Carter et al. 2003). The relaxation response counteracts the effects of sympathetic activity by bolstering the parasympathetic nervous system’s ability to regulate blood pressure. Reduced sympathetic activity causes a drop in blood pressure via decreasing plasma renin-angiotensin activity and aldosterone concentration (Broms, 1999).

This study has several limitations that need to be considered. Firstly, there is a limited number of studies specifically focusing on CAM interventions for postpartum preeclampsia, necessitating the inclusion of studies on pre-eclampsia that may not directly apply to the postpartum period. Secondly, the variability in study designs, outcome measures, and participant characteristics adds complexity to drawing definitive conclusions. Additionally, the lack of standardized protocols and guidelines for CAM interventions in postpartum preeclampsia hampers consistent evaluation and comparison. Furthermore, the potential for publication bias and variations in the quality of included studies impact the overall strength of the evidence. Future research should address these limitations and prioritize targeted studies on CAM interventions specifically for postpartum preeclampsia to enhance the evidence base and inform clinical practice.