Comparing the effects of vaginal and oral evening primrose oil on cervical ripening and labor progress among primiparous women
,
Abstract
Background & Aim: Evening primrose is a medicinal plant with potential effects on labor. This study aimed to compare the effects of vaginal and oral evening primrose oil on cervical ripening and labor progress among primiparous women.
Methods & Materials: This single-blind randomized clinical trial was conducted in 2020. Participants were 126 pregnant women with a gestational age of 39 weeks purposively selected from the obstetrics and gynecology ward of Valiasr hospital, Bafgh, Iran, and randomly allocated to vaginal evening primrose oil, oral evening primrose oil, and a control group. Participants in the vaginal evening primrose oil and the oral evening primrose oil groups received one 1000-mg evening primrose oil capsule per twelve hours for one whole week through the vaginal and the oral routes, respectively. The Bishop score and pregnancy outcomes were measured when participants referred to the study setting with labor pains.
Results: After the intervention, the Bishop score in both intervention groups was significantly greater than the control group (P= 0.001). The length of the second stage of labor in the vaginal evening primrose oil group was significantly shorter than the control group (P= 0.009). There were no significant differences among the groups respecting the time interval between hospital admission and delivery (P= 0.21), 1 and 5-minute Apgar scores (P= 0.83), and (P= 0.37), need for induction (P= 0.26), and type of delivery (P= 0.26).
Conclusion: Vaginal and oral evening primrose oil administrations have significant positive effects on cervical ripening and the Bishop score and vaginal evening primrose oil have significant positive effects on the length of the second stage of labor.
1. Vitner D, Bleicher I, Kadour-Peero E, Borenstein-Levin L, Kugelman A, Sagi S, Gonen R. Induction of labor versus expectant management among women with macrosomic neonates: a retrospective study. The Journal of Maternal-Fetal & Neonatal Medicine. 2020 Jun 2;33(11):1831-9.
2. Dashe JS, Bloom SL, Spong CY, Hoffman BL. Williams obstetrics. McGraw Hill Professional; 2018 Jun 1.
3. Luesley DM, Kilby M, editors. Obstetrics & Gynaecology: An evidence-based text for MRCOG. CRC Press; 2016 Mar 30.
4. Myers KM, Feltovich H, Mazza E, Vink J, Bajka M, Wapner RJ, Hall TJ, House M. The mechanical role of the cervix in pregnancy. Journal of Biomechanics. 2015 Jun 25;48(9):1511-23.
5. Soh YM, Tiwari A, Mahendroo M, Conrad KP, Parry LJ. Relaxin regulates hyaluronan synthesis and aquaporins in the cervix of late pregnant mice. Endocrinology. 2012 Dec 1;153(12):6054-64.
6. Wormer, Kelly C., Amelia Bauer, and Ann E. Williford. "Bishop Score." [Updated 2021 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470368/
7. Jahani Shourab N, Mirteimouri M, Latifnejad Roudsari R. A case series of severe perineal lacerations during normal childbirth. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(8):103-14.
8. Naeiji Z, Naghshvarian N, Mirzamoradi M, Sotudeh S, Moridi A. Efficacy and safety of oral hyoscine used for outpatient cervical ripening among primiparous women with term pregnancy. International Journal of Gynecology & Obstetrics. 2020 Sep;150(3):335-9.
9. Levine LD. Cervical ripening: Why we do what we do. Semin Perinatol. 2020 Mar;44(2):151216.
10. K Kim HI, Choo SP, Han SW, Kim EH. Benefits and risks of induction of labor at 39 or more weeks in uncomplicated nulliparous women: A retrospective, observational study. Obstetrics & Gynecology Science. 2019 Jan 1;62(1):19-26.
11. Pierce S, Bakker R, Myers DA, Edwards RK. Clinical insights for cervical ripening and labor induction using prostaglandins. American Journal of Perinatology Reports. 2018 Oct;8(04):e307-14.
12. Rath W, Kehl S. The renaissance of transcervical balloon catheters for cervical ripening and labour induction. Geburtshilfe und Frauenheilkunde. 2015 Nov;75(11):1130-9.
13. Stephenson ML, Wing DA. A novel misoprostol delivery system for induction of labor: clinical utility and patient considerations. Drug Design, Development and Therapy. 2015;9:2321-7.
14. Tabasi Z, Mesdaghinia E, Abedzadeh-Kalahroudi M, Sehat M, Panahandeh A. Comparing the effects of vaginal misoprostol, laminaria, and extra amniotic saline infusion on cervical ripening and induction of labor. Obstetrics & Gynecology Science. 2020 Mar 30;63(3):261-9.
15. Kam PC, Barnett DW, Douglas ID. Herbal medicines and pregnancy: A narrative review and anaesthetic considerations. Anaesthesia and Intensive Care. 2019 May;47(3):226-34.
16. Gholami F, Samani LN, Kashanian M, Naseri M, Hosseini AF, Nejad SA. Onset of labor in post-term pregnancy by chamomile. Iranian Red Crescent Medical Journal. 2016 Nov;18(11):e19871.
17. TORK ZS, Dasumi S, Tansaz M, Akbarzadeh A. The effects ofpeganeum harmala smoke cervical ripening, initiation and outcome of labor. Medical History Journal, 8(27): 151-77. [Persian]
18. Zorzan M, Zucca P, Collazuol D, Peddio S, Rescigno A, Pezzani R. Sisymbrium officinale, the plant of singers: A review of its properties and uses. Planta Medica. 2020 Mar;86(05):307-11.
19. Kahnamoyiagdam F, Aghamohammadi M, Rostamnejad M. The effect of castor oil on the induction of labor: A clinical trial. Nursing And Midwifery Journal. 2014 Aug 10;12(5):348-53.
20. Darooneh T, Rashidi Fakari F, Moattar F, Nasiri M, Delpak-Yeganeh S, Esmaeili S, Ozgoli G. Effect of Crocus sativus (Saffron) on Cervical Ripening and Progress of Labor in Primiparous Term Women: A Randomized Double-Blind Placebo-Controlled Trial. International Journal of Pediatrics. 2020 Sep 1;8(9):12105-15.
21. Tanchuling MP. Comparison of evening primrose oil and dinoprostone in labor induction of term singleton pregnancies. Special Issue: Abstracts of the XXII FIGO World Congress of Gynecology & Obstetrics. International Journal of Gynecology and Obstetrics. 2018;143(S3):229-30.
22. Pineda ME. Effectiveness of intravaginal evening primrose oil as a cervical ripening agent in nulliparous women: A double blinded randomized controlled clinical trial. In25th Asian & Oceanic Congress of Obstetrics & Gynaecology 2017 Jun (pp. 15-18).
23. Zand Vakili F, Zare SH, Rahimi K, Riahi M. The effect of Evening Primrose Oil on Changes in Polycystic Ovary Syndrome Induced by Estradiol Valerate in Rat. Armaghane Danesh. 2018 Feb 10;22(6):714-24. [Persian]
24. Shahali S, Khatami F, Abbaspoor Z, Gheraghian B. The effect of vaginal evening primrose capsule on cervical ripening in nulliparous women with post-term pregnancy: A clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(8):30-8. [Persian]
25. Khorshidi M, Zarezadeh M, Moradi Moghaddam O, Emami MR, Kord‐Varkaneh H, Mousavi SM, Alizadeh S, Heshmati J, Olang B, Aryaeian N. Effect of evening primrose oil supplementation on lipid profile: A systematic review and meta‐analysis of randomized clinical trials. Phytotherapy Research. 2020 Oct;34(10):2628-38. [Persian]
26. Nikoomazhab S, Latifi SM, Honarmandpour A, Abedi P. Effects of evening primrose oil on prevention of postpartum grief in primiparous women: A clinical double-blind randomized controlled trial. Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;20(11):64-73. [Persian]
27. Pizzorno JE, Murray MT, Joiner-Bey H. The Clinician's Handbook of Natural Medicine E-Book. Elsevier Health Sciences; 2016 Jan 5.
28. Mahboubi M. Evening primrose (Oenothera biennis) oil in management of female ailments. Journal of Menopausal Medicine. 2019 Aug 1;25(2):74-82.
29. Shayan A, Ahmadinia H, Masoumi SZ, Shobeiri F, Moradkhani S, Sourinezhad H. The Effect of Evening Primrose and vitamin B6 on premenstrual syndrome: A randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2019;21(12):37-48.
30. Nonette DN. The effectiveness of evening primrose oil gel capsule as a cervical ripening agent during labor induction as measured by bishop score on term singleton pregnant patients. Philippine Journal of Obstetrics and Gynecology. 2017;41(2):1-4.
31. Hashemnejad M, Ataei M, Modarresi M, Forutan F. Investigating the effect of Primrose Capsule (Primula Flower Oil) on cervix preparation and commencement of child delivery pains. Revista Latinoamericana de Hipertensión. 2019;14(1):119.
32. Nia SS, Safi F, Shoukrpour M, Kamali A. An investigation into the effect of evening primrose in dilatation of cervix and pain during and after hysterosalpingography. Journal of Medicine and Life. 2019 Jul;12(3):284-9.
33. Girlie VB. The efficacy of evening primrose oil as a cervical ripening agent for gynecologic procedures: A single-blinded, randomized controlled trial. Philippine Journal of Obstetrics and Gynecology. 2015:25-8.
34. Najafi M, Loripoor M, Saghafi Z, Kazemi M. The effect of vaginal evening primrose on the Bishop score of term nulliparous women. Nursing Practice Today. 2019 Oct 1;6(4):202-11.
35. Hiersch L, Borovich A, Gabbay-Benziv R, Maimon-Cohen M, Aviram A, Yogev Y, Ashwal E. Can we predict successful cervical ripening with prostaglandin E2 vaginal inserts?. Archives of Gynecology and Obstetrics. 2017 Feb;295(2):343-9.
36. Kalati M, Kashanian M, Jahdi F, Naseri M, Haghani H, Sheikhansari N. Evening primrose oil and labour, is it effective? A randomised clinical trial. Journal of Obstetrics and Gynaecology. 2018 May 19;38(4):488-92.
37. Faghani Aghoozi M, Fayazi S, Mohammadi S, Tehranian N, Amerian M. The effects of evening primerose on clinical obstetrics of Iran: a review study. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2019 Dec 10;5(3):15-28.
38. Esmaeilzadeh M, Moradi B. Medicinal herbs with side effects during pregnancy-An evidence-based review article. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2017;20:9-25. [Persian]
2. Dashe JS, Bloom SL, Spong CY, Hoffman BL. Williams obstetrics. McGraw Hill Professional; 2018 Jun 1.
3. Luesley DM, Kilby M, editors. Obstetrics & Gynaecology: An evidence-based text for MRCOG. CRC Press; 2016 Mar 30.
4. Myers KM, Feltovich H, Mazza E, Vink J, Bajka M, Wapner RJ, Hall TJ, House M. The mechanical role of the cervix in pregnancy. Journal of Biomechanics. 2015 Jun 25;48(9):1511-23.
5. Soh YM, Tiwari A, Mahendroo M, Conrad KP, Parry LJ. Relaxin regulates hyaluronan synthesis and aquaporins in the cervix of late pregnant mice. Endocrinology. 2012 Dec 1;153(12):6054-64.
6. Wormer, Kelly C., Amelia Bauer, and Ann E. Williford. "Bishop Score." [Updated 2021 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470368/
7. Jahani Shourab N, Mirteimouri M, Latifnejad Roudsari R. A case series of severe perineal lacerations during normal childbirth. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(8):103-14.
8. Naeiji Z, Naghshvarian N, Mirzamoradi M, Sotudeh S, Moridi A. Efficacy and safety of oral hyoscine used for outpatient cervical ripening among primiparous women with term pregnancy. International Journal of Gynecology & Obstetrics. 2020 Sep;150(3):335-9.
9. Levine LD. Cervical ripening: Why we do what we do. Semin Perinatol. 2020 Mar;44(2):151216.
10. K Kim HI, Choo SP, Han SW, Kim EH. Benefits and risks of induction of labor at 39 or more weeks in uncomplicated nulliparous women: A retrospective, observational study. Obstetrics & Gynecology Science. 2019 Jan 1;62(1):19-26.
11. Pierce S, Bakker R, Myers DA, Edwards RK. Clinical insights for cervical ripening and labor induction using prostaglandins. American Journal of Perinatology Reports. 2018 Oct;8(04):e307-14.
12. Rath W, Kehl S. The renaissance of transcervical balloon catheters for cervical ripening and labour induction. Geburtshilfe und Frauenheilkunde. 2015 Nov;75(11):1130-9.
13. Stephenson ML, Wing DA. A novel misoprostol delivery system for induction of labor: clinical utility and patient considerations. Drug Design, Development and Therapy. 2015;9:2321-7.
14. Tabasi Z, Mesdaghinia E, Abedzadeh-Kalahroudi M, Sehat M, Panahandeh A. Comparing the effects of vaginal misoprostol, laminaria, and extra amniotic saline infusion on cervical ripening and induction of labor. Obstetrics & Gynecology Science. 2020 Mar 30;63(3):261-9.
15. Kam PC, Barnett DW, Douglas ID. Herbal medicines and pregnancy: A narrative review and anaesthetic considerations. Anaesthesia and Intensive Care. 2019 May;47(3):226-34.
16. Gholami F, Samani LN, Kashanian M, Naseri M, Hosseini AF, Nejad SA. Onset of labor in post-term pregnancy by chamomile. Iranian Red Crescent Medical Journal. 2016 Nov;18(11):e19871.
17. TORK ZS, Dasumi S, Tansaz M, Akbarzadeh A. The effects ofpeganeum harmala smoke cervical ripening, initiation and outcome of labor. Medical History Journal, 8(27): 151-77. [Persian]
18. Zorzan M, Zucca P, Collazuol D, Peddio S, Rescigno A, Pezzani R. Sisymbrium officinale, the plant of singers: A review of its properties and uses. Planta Medica. 2020 Mar;86(05):307-11.
19. Kahnamoyiagdam F, Aghamohammadi M, Rostamnejad M. The effect of castor oil on the induction of labor: A clinical trial. Nursing And Midwifery Journal. 2014 Aug 10;12(5):348-53.
20. Darooneh T, Rashidi Fakari F, Moattar F, Nasiri M, Delpak-Yeganeh S, Esmaeili S, Ozgoli G. Effect of Crocus sativus (Saffron) on Cervical Ripening and Progress of Labor in Primiparous Term Women: A Randomized Double-Blind Placebo-Controlled Trial. International Journal of Pediatrics. 2020 Sep 1;8(9):12105-15.
21. Tanchuling MP. Comparison of evening primrose oil and dinoprostone in labor induction of term singleton pregnancies. Special Issue: Abstracts of the XXII FIGO World Congress of Gynecology & Obstetrics. International Journal of Gynecology and Obstetrics. 2018;143(S3):229-30.
22. Pineda ME. Effectiveness of intravaginal evening primrose oil as a cervical ripening agent in nulliparous women: A double blinded randomized controlled clinical trial. In25th Asian & Oceanic Congress of Obstetrics & Gynaecology 2017 Jun (pp. 15-18).
23. Zand Vakili F, Zare SH, Rahimi K, Riahi M. The effect of Evening Primrose Oil on Changes in Polycystic Ovary Syndrome Induced by Estradiol Valerate in Rat. Armaghane Danesh. 2018 Feb 10;22(6):714-24. [Persian]
24. Shahali S, Khatami F, Abbaspoor Z, Gheraghian B. The effect of vaginal evening primrose capsule on cervical ripening in nulliparous women with post-term pregnancy: A clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21(8):30-8. [Persian]
25. Khorshidi M, Zarezadeh M, Moradi Moghaddam O, Emami MR, Kord‐Varkaneh H, Mousavi SM, Alizadeh S, Heshmati J, Olang B, Aryaeian N. Effect of evening primrose oil supplementation on lipid profile: A systematic review and meta‐analysis of randomized clinical trials. Phytotherapy Research. 2020 Oct;34(10):2628-38. [Persian]
26. Nikoomazhab S, Latifi SM, Honarmandpour A, Abedi P. Effects of evening primrose oil on prevention of postpartum grief in primiparous women: A clinical double-blind randomized controlled trial. Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;20(11):64-73. [Persian]
27. Pizzorno JE, Murray MT, Joiner-Bey H. The Clinician's Handbook of Natural Medicine E-Book. Elsevier Health Sciences; 2016 Jan 5.
28. Mahboubi M. Evening primrose (Oenothera biennis) oil in management of female ailments. Journal of Menopausal Medicine. 2019 Aug 1;25(2):74-82.
29. Shayan A, Ahmadinia H, Masoumi SZ, Shobeiri F, Moradkhani S, Sourinezhad H. The Effect of Evening Primrose and vitamin B6 on premenstrual syndrome: A randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2019;21(12):37-48.
30. Nonette DN. The effectiveness of evening primrose oil gel capsule as a cervical ripening agent during labor induction as measured by bishop score on term singleton pregnant patients. Philippine Journal of Obstetrics and Gynecology. 2017;41(2):1-4.
31. Hashemnejad M, Ataei M, Modarresi M, Forutan F. Investigating the effect of Primrose Capsule (Primula Flower Oil) on cervix preparation and commencement of child delivery pains. Revista Latinoamericana de Hipertensión. 2019;14(1):119.
32. Nia SS, Safi F, Shoukrpour M, Kamali A. An investigation into the effect of evening primrose in dilatation of cervix and pain during and after hysterosalpingography. Journal of Medicine and Life. 2019 Jul;12(3):284-9.
33. Girlie VB. The efficacy of evening primrose oil as a cervical ripening agent for gynecologic procedures: A single-blinded, randomized controlled trial. Philippine Journal of Obstetrics and Gynecology. 2015:25-8.
34. Najafi M, Loripoor M, Saghafi Z, Kazemi M. The effect of vaginal evening primrose on the Bishop score of term nulliparous women. Nursing Practice Today. 2019 Oct 1;6(4):202-11.
35. Hiersch L, Borovich A, Gabbay-Benziv R, Maimon-Cohen M, Aviram A, Yogev Y, Ashwal E. Can we predict successful cervical ripening with prostaglandin E2 vaginal inserts?. Archives of Gynecology and Obstetrics. 2017 Feb;295(2):343-9.
36. Kalati M, Kashanian M, Jahdi F, Naseri M, Haghani H, Sheikhansari N. Evening primrose oil and labour, is it effective? A randomised clinical trial. Journal of Obstetrics and Gynaecology. 2018 May 19;38(4):488-92.
37. Faghani Aghoozi M, Fayazi S, Mohammadi S, Tehranian N, Amerian M. The effects of evening primerose on clinical obstetrics of Iran: a review study. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2019 Dec 10;5(3):15-28.
38. Esmaeilzadeh M, Moradi B. Medicinal herbs with side effects during pregnancy-An evidence-based review article. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2017;20:9-25. [Persian]
| Files | ||
| Issue | Vol 9 No 3 (2022): Summer | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v9i3.10225 | |
| Keywords | ||
| cervical ripening; evening primrose; child labor | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Heydari P, Azizi F, Khakbazan Z, Geranmayeh M. Comparing the effects of vaginal and oral evening primrose oil on cervical ripening and labor progress among primiparous women. NPT. 2022;9(3):234-242.
