The Use of Oral Evening Primrose Oil versus Placebo for Ripening of the Cervix in Term Primgravidas (A Randomized Controlled Trial)

Abstract

When labor is induced, cervical status has an impact on the duration of induction and the likelihood of vaginal delivery. If the cervical status is unfavorable, a ripening process is generally employed prior to induction to shorten the duration of induction and maximize the possibility of vaginal delivery. Although cervical status at induction provides insight into the chance of cesarean delivery, it does not predict whether avoiding labor induction and managing the patient expectantly will result in a higher chance of vaginal delivery Cervical ripening before the onset of labor is an important factor for the prediction of delivery mode, and is directly associated with vaginal delivery. The search for a safe, inexpensive, and easy method of cervical ripening is of great significance. Prostaglandins of E series are effective in dilatation and ripening of the cervix, but some of them such as dinoproston require special storage temperatures EPO is traditionally used among Native American pregnant women to ease the cervical priming. Most studies show that synthetic prostaglandins play an important role in cervical ripening, but prostaglandins have some side effects, are not easily available, and are relatively expensive. EPO is a precursor of prostaglandins, especially PGE1 in a readily bioavailable form to the human body. Compared to misoprostol, EPO is an herbal oil with no or a few side effects, is less expensive, more available and easy to use. The study showed that the mean bishop score of the EPO group was significantly higher than the placebo group after the intervention. Also, there was a significant reduction in cervical length measured by transvaginal ultrasound in EPO group than the placebo group after the intervention