The Effect of Alcea Angulata in Combination with Honey for Cervical Ripening in Nulliparous Women: A Randomized Controlled Trial

Background & Objective: Oral consumption of Alcea Angulata species, which contains tannins, calcium, and carbohydrates, can induce contractions and facilitate childbirth during uncomplicated pregnancies. The present study was conducted with aim to assess the effect of Alcea Angulata in combination with honey for cervical ripening in nulliparous women. Materials & Methods: This randomized controlled trial study was conducted on 80 nulliparous women at 39 weeks of gestation who were divided into two groups: the intervention group received Alcea Angulata powder and honey (n=40), and the control group received no intervention (n=40). Outcomes were measured from the start of the intervention to delivery, including the interval from intervention to delivery, Bishop score, mode of delivery, delivery complications, Apgar scores at 1st and 5th minutes, need for neonatal resuscitation, and presence of meconium-stained amniotic fluid. Bishop score and stripping score were also monitored weekly until 40th week of pregnancy and on days 2, 4, and 6 post-due date if no delivery occurred. Results: The mean scores of the interval between first intervention and delivery time were 131.3±77.8 and 132.1±107.3 h in the intervention and control groups, respectively (P=0.633). Moreover, the two groups did not significantly differ regarding 1-minute Apgar score (P=0.197), 5-minute Apgar score (P=0.429), need for neonatal resuscitation (P=0.099), and meconium-stained amniotic fluid (P=0.099). Conclusion: The use of Alcea Angulata with honey did not significantly affect the time between intervention and delivery. It also showed no significant negative neonatal outcomes, suggesting the safety of the intervention.