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Castor oil is a known preparation for induction of labor widely used among midwives and delivery rooms around the world. We have studied the efficacy and safety of castor oil for induction of labor in post date pregnancies
A prospective, randomized, double blind and placebo controlled study was conducted. Criteria for eligibility were singleton pregnancy, 40-42 weeks, Bishop Score ≤7, no uterine activity and no previous cesarean section. Treatment and control groups received 60ml of castor oil and placebo orally, respectively. Logistic regression was used to compare the odds of entering active phase of delivery within 12 hours of administration of intervention between the two groups. Kaplan-Meier analysis (Survival analysis) was performed to compare the time from administration of intervention to entering active phase of labor.
A total of eighty women were recruited for this study (37 in the treatment groop & 43 to the control group). Characteristics of participants were similar between the groups. We found that the odds of entering active phase of labor within 12 hours of administration of intervention was 3 times higher among women receiving castor oil compared to women receiving placebo (p=0.034). Further adjustment for parity and age augmented these findings (Odds ratio=3.94, p=0.017). Additionally, Kaplan-Meier analysis following up participants 48 hours postadministration of treatment demonstrated that women receiving castor oil were likely to enter the active phase of labor somewhat faster than controls (p=0.077) (Figure). Thus, this may suggest that the potential effect of castor oil on induction of labor may extend beyond the first 12 hours of its administration. No differences between the two groups were found in labor complications and neonatal outcomes (table 1) .
In this trial we have shown, for the first time in a RCT, that castor oil is a safe and effective substance for induction of labor in post-date pregnancies. Its safety profile, even in an out-patient set-up, adds to its value as a reliable “natural” modality to induce labor.