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1- The Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , nouri@sbmu.com
2- Physiotherapy Research Center, Department of Biostatics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Department of Obstetrics and Gynecology, Shohaday-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:   (40 Views)
Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial (RCT) aimed to compare the effect of EPO and misoprostol on cervical ripening/dilatation.
Methods: In this double–blind RCT study, women of reproductive age without history of normal vaginal delivery (NVD) and menopause women (age range: 20–75 years) were enrolled. The subjects who were candidates of hysteroscopy, dilatation, and curettage were randomly assigned into two groups. In one group, 2 capsules of 500 mg EPO (N=81) and in the other group 2 capsules of 200 µg misoprostol (N=84) were placed in posterior fornix 2 hours before surgery. The time to reach complete dilatation (Hegar 3 to 10 mm), size of the first Hegar used to apply force, bleeding volume, and cervical laceration were compared between the groups using the IBM SPSS Statistics for Windows, Version 21.0 (Armonk, NY: IBM Corp).
Results: The two study groups had similar demographic information, number of pregnancies, cesarean sections, and NVDs (P>.05), but had different frequency of surgical types (P=.018). EPO group had a larger mean size of the Hegar (7.32 vs. 6.58 mm; P=.004) and shorter time to reach complete dilatation (242.35 vs. 331.79 min; P=.002); however, bleeding volume and frequency of cervical laceration were not different between the groups (1.41 vs. 2.00 cc and 8.6% vs. 14.3%, respectively; P>.05).
Conclusion: The superiority of EPO capsules to misoprostol for cervical ripening before gynecologic procedures in women of reproductive age without history of normal NVD and menopause women suggests it as an appropriate alternative to misoprostol.
     
Systematic Review: Original Research | Subject: General Gynecology and Pelvic Floor,
Received: 2021/01/12 | Accepted: 2021/01/13

References
1. Gilstrop M, Sciscione A, editors. Induction of labor—Pharmacology methods. Seminars in perinatology; 2015: Elsevier.
2. Ramirez MM. Labor induction: a review of current methods. Obstetrics and Gynecology Clinics. 2011;38(2):215-25. [DOI:10.1016/j.ogc.2011.02.012] [PMID]
3. Sciscione AC. Methods of cervical ripening and labor induction: mechanical. Clinical obstetrics and gynecology. 2014;57(2):369-76. [DOI:10.1097/GRF.0000000000000023] [PMID]
4. Bakker R, Pierce S, Myers D. The role of prostaglandins E1 and E2, dinoprostone, and misoprostol in cervical ripening and the induction of labor: a mechanistic approach. Archives of gynecology and obstetrics. 2017;296(2):167-79. [DOI:10.1007/s00404-017-4418-5] [PMID]
5. Chatsis V, Frey N. Misoprostol for Cervical Ripening and Induction of Labour: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines. 2018.
6. Alfirevic Z, Keeney E, Dowswell T, Welton NJ, Medley N, Dias S, et al. Which method is best for the induction of labour?: A systematic review, network meta-analysis and cost-effectiveness analysis. Health technology assessment. 2016. [DOI:10.3310/hta20650] [PMID] [PMCID]
7. Gkrozou F, Koliopoulos G, Vrekoussis T, Valasoulis G, Lavasidis L, Navrozoglou I, et al. A systematic review and meta-analysis of randomized studies comparing misoprostol versus placebo for cervical ripening prior to hysteroscopy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2011;158(1):17-23. [DOI:10.1016/j.ejogrb.2011.04.022] [PMID]
8. Farzaneh F, Fatehi S, Sohrabi M-R, Alizadeh K. The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Archives of gynecology and obstetrics. 2013;288(5):1075-9. [DOI:10.1007/s00404-013-2852-6] [PMID]
9. Bamford JT, Ray S, Musekiwa A, van Gool C, Humphreys R, Ernst E. Oral evening primrose oil and borage oil for eczema. Cochrane Database of Systematic Reviews. 2013(4). [DOI:10.1002/14651858.CD004416.pub2] [PMID]
10. 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.
11. Bahmani S, Hesamy K, Shahgheibi S, Roshani D, Shahoei R. Comparison of the Effect of Vaginal Capsule of Evening Primrose Oil and Misoprostol on Cervical Ripening of Nulliparous Women with Post-term Pregnancy. Journal of Pharmaceutical Research International. 2019:1-9. [DOI:10.9734/jpri/2019/v26i330140]
12. 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.
13. Jahdi F, Kalati M, Kashanian M, Naseri M, Haghani H. Effect of oral evening primrose capsules on ripening of the cervix in nulliparous iranian pregnant women (a randomized trial). Acta Medica Mediterranea. 2016;32(Specia):1273-9.
14. 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;38(4):488-92. [DOI:10.1080/01443615.2017.1386165] [PMID]
15. Vahdat M, Tahermanesh K, Kashi AM, Ashouri M, Dodaran MS, Kashanian M, et al. Evening primrose oil effect on the ease of cervical ripening and dilatation before operative hysteroscopy. Thrita. 2015;4(3). [DOI:10.5812/thrita.29876]
16. Aquino P, Fernandez H, Garcia M, Barrientos M, Apepe E, Pichay R. Determining the Ease of Cervical Dilation in Patients Given Evening Primrose Oil (Eveprim®) Intravaginally before Hysteroscopy in Postmenopausal and Nulliparous, Premenopausal Women Ages 37-77 Years Old: A Pilot Study. Journal of Minimally Invasive Gynecology. 2011;18(6):S126-S7. [DOI:10.1016/j.jmig.2011.08.518]
17. Darwish A, Ahmad A, Mohammad A. Cervical priming prior to operative hysteroscopy: a randomized comparison of laminaria versus misoprostol. Human reproduction. 2004;19(10):2391-4. [DOI:10.1093/humrep/deh397] [PMID]
18. Marian C. A randomized controlled trial of evening primrose oil for cervical priming prior to operative hysterroscopy. Philippine Journal of Reproductive Endocrinology and Infertility. 2009;6(2):35-40.
19. Mahboubi M. Evening Primrose (Oenothera biennis) Oil in Management of Female Ailments. Journal of menopausal medicine. 2019;25(2):74-82. [DOI:10.6118/jmm.18190] [PMID] [PMCID]
20. Tanchoco M, Aguilar A. Cervical priming prior to operative hysteroscopy: a randomized controlled study comparing the efficacy of laminaria versus evening primrose oil (EPO). Journal of minimally invasive gynecology. 2015;22(6):S45. [DOI:10.1016/j.jmig.2015.08.122] [PMID]
21. Allen R, O'Brien BM. Uses of misoprostol in obstetrics and gynecology. Reviews in obstetrics and gynecology. 2009;2(3):159.
22. Hua Y, Zhang W, Hu X, Yang A, Zhu X. The use of misoprostol for cervical priming prior to hysteroscopy: a systematic review and analysis. Drug design, development and therapy. 2016;10:2789. [DOI:10.2147/DDDT.S111625] [PMID] [PMCID]
23. Pierce S, Bakker R, Myers DA, Edwards RK. Clinical Insights for Cervical Ripening and Labor Induction Using Prostaglandins. American Journal of Perinatology Reports. 2018;8(04):e307-e14. [DOI:10.1055/s-0038-1675351] [PMID] [PMCID]
24. Al‐Fozan H, Firwana B, Al Kadri H, Hassan S, Tulandi T. Preoperative ripening of the cervix before operative hysteroscopy. Cochrane Database of Systematic Reviews. 2015(4). [DOI:10.1002/14651858.CD005998.pub2] [PMID]
25. Harper M, Moutrey S, Clark NJ. Preoperative ripening of the cervix before operative hysteroscopy. Journal of Perioperative Practice. 2017.
26. Polyzos N, Zavos A, Valachis A, Dragamestianos C, Blockeel C, Stoop D, et al. Misoprostol prior to hysteroscopy in premenopausal and post-menopausal women. A systematic review and meta-analysis. Human reproduction update. 2012;18(4):393-404. [DOI:10.1093/humupd/dms014] [PMID]
27. Sordia-Hernández LH, Rosales-Tristan E, Vazquez-Mendez J, Merino M, Iglesias JL, Garza-Leal JG, et al. Effectiveness of misoprostol for office hysteroscopy without anesthesia in infertile patients. Fertility and sterility. 2011;95(2):759-61. [DOI:10.1016/j.fertnstert.2010.07.1066] [PMID]

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