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Background and Purpose: The role of castor oil on cervical ripening is poorly understood and data in examining its efficacy within clinical trial are limited. This study was performed to evaluate the effect of utilizing castor oil on cervical ripening in pregnancies after 40 weeks.
Materials and Methods: A randomized clinical trial study was performed on 200 pregnant women after 40 weeks in Shabikhany Hospital, in the City of Kashan, in 2004 to 2006. Women were divided to two groups (100 women in case group and 100 women in control group). Case group took 60 ml castor oil, while the control group omitted treatment. Comparison was then compared between the two groups for demographic characteristics: increase of Bishop Score, means of Bishop Score at entrance to study and 24 hours after entrance to study, onset of labor within 24 hours, method and time of delivery and newborns Apgar score by X2, followed by Fisher’s exact test, and paired-samples T and T-tests.
Results: Results showed that there were no significant differences in mother’s age, education, nationality, gravidity, gestational age, parity between two groups. Paired-sample T test showed significant difference between means of Bishop Score at entrance of study and 24 hours after entrance of study in case and control groups(p=0.00). Furthermore, the mean increase of Bishop score in the case group was 4.5±3.63 versus 0.67±1.25 in the control group during the 24 hour period. During 24 hours after entrance to study, uterine contraction occurred in 70% women in case and 12% women in control groups. Statistical test showed significant difference between the two groups and an increase of Bishop Score at the onset of uterine contractions (P<0.001). There were no significant differences in method of delivery and Apgar score in their newborns between the two groups.
Conclusion: The results of this study showed that use of castor oil may lead to cervical ripening in pregnant women after 40 weeks, without increase in complication of pregnancy, such as caesarean, and decrease Apgar score.

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Background and purpose: Prostaglandin Ë2 and intracervical catheter are two categories of cervical ripening before induction of labor. The aim of this study was to compare the effectiveness of the intracervical foley balloon catheter and 3 mg prostaglandin Ë2 tablet in preinduction of cervical ripening.
Materials and methods: Ïn this clinical trial study, 89 primigravid women hospitalized for induction of labor with a Bishop score of less than 5 were randomized to receive either an intracervical foley catheter (n=45) or prostaglandin Ë2 tablets (n=44). Çervical ripening, frequent use of oxytocine, mode of delivery and maternal morbidity were the main outcome measures. Fisher's exact test, Mann-Whitney, paired T-test and T-test were used for data analysis using SPSS version 15.
Results: The mean age of patients in prostaglandin Ë2 and intracervical catheter groups were 23.3 ± 3.8 and 23 ± 3.4 years, respectively (P>0.05). There were no significant differences in primary mean Bishop Scores between the two groups (P>0.05). Bishop Scores (mean ± S.D) after ripening were (5.8 ± 1.4) for the foley catheter and (6.4 ± 1.6) for the prostaglandin groups (P>0.05). Üse of oxytocin were more frequent in the foley catheter group (P<0.05). The rates of Çesarean section in prostaglandin Ë2 and intracervical foley groups were 40.9% and 33.3%, respectively, however, this difference was not statistically significant. No significant difference was found in terms of maternal morbidity rate between the two groups.
Çonclusion: Ëfficacy of Prostaglandin Ë2 and intracervical foley catheter were the same in preinduction of cervical ripening.

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 Background and purpose: Cervical ripening is of great importance in gynecology. Evening primrose is one of the medicinal plants used for cervical ripening and softening before midwifery and labor interventions. The present study aimed to review the clinical trials on the effect of evening primrose on cervical ripening and labor.
Materials and methods: In this narrative review, search was done in Scopus, PubMed, Library Cochrane, Embase, Magiran, SID, Web of Science, and Google Scholar to find relevant studies published until May 2020. Clinical studies and quasi-experimental trials published in Persian and English were included. Persian and English keywords including Bishop Score, cervix, evening primrose and their combinations were used. The Jadad scale was used to assess the quality of articles.
Results: A total of 283 articles were found and finally 10 interventional studies, including clinical trials and quasi–experimental studies that met the inclusion criteria were reviewed. Among these studies, three were performed on women candidates for gynecological interventions and indicated positive effects of evening primrose on cervical ripening. Other studies were done in pregnant women, but there was not enough evidence on the effect of evening primroses and its effects in pregnancy.
Conclusion: No reliable evidence was found on the positive effect of evening primrose on cervical ripening. Therefore, further studies are needed before using this medicinal plant in clinical practice.