Publications (2)3.75 Total impact
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Article: Castor Oil for Induction of Labor: Not Harmful, Not Helpful
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ABSTRACT: Although published data on the safety and effectiveness of castor oil for the induction of labor are sparse, it is widely used for this purpose outside of medical settings, especially by American nurse-midwives. Its low cost, easy storage, and apparent safety contribute to its popularity. The results of 4 small clinical trials evaluating its safety and effectiveness for labor induction were contradictory. This historical cohort investigated the safety and effectiveness of castor oil for induction of labor in women with an estimated gestation of more than 40 weeks based on ultrasound. Data were obtained from the hospital-based records of pregnant women who had attended antenatal clinics on the Thai-Burmese border between 2005 and 2007. The 612 women (18.1%) who delivered during the study period at a gestational age of more than 40 weeks were divided into 2 groups: those who were prescribed oral doses of castor oil (n = 205) and those who were not (n = 407). A Cox proportional hazards regression model was used to measure the effect of castor oil on the time to delivery. The Fisher exact test was used to compare proportions of women with various identified adverse outcomes. Primary outcomes examined in the safety analysis were maternal deaths and stillbirths. Other analyzed safety measures included fetal distress, meconium-stained amniotic fluid, uterine tachysystole, uterine rupture, abnormal maternal blood pressure during labor, Apgar score, neonatal resuscitation, postpartum hemorrhage, and severe diarrhea. No significant difference was found in the time to birth of women who received castor oil and those who did not; the hazard ratio was 0.99, with a 95% confidence interval of 0.81–1.20. There were no maternal deaths, uterine ruptures, or other harmful effects on the mother or fetus associated with either group. In this study, the use of castor was safe for both mothers and babies but the data provide no evidence that this agent is effective for induction of labor.Obstetrical and Gynecological Survey 01/2010; 65(2):77-78. · 2.51 Impact Factor -
Article: Castor oil for induction of labour: not harmful, not helpful.
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ABSTRACT: Castor oil is one of the most popular drugs for induction of labour in a non-medical setting; however, published data on safety and effectiveness of this compound to induce labour remain sparse. To assess the safety and effectiveness of castor oil for induction of labour in pregnancies with an ultrasound estimated gestational at birth of more than 40 weeks. Data were extracted from hospital-based records of all pregnant women who attended antenatal clinics on the Thai-Burmese border and who were more than 40 weeks pregnant. The effectiveness of castor oil to induce labour was expressed as time to birth and analysed with a Cox proportional hazards regression model. Measures associated with safety were fetal distress, meconium-stained amniotic fluid, tachysystole of the uterus, uterine rupture, abnormal maternal blood pressure during labour, Apgar scores, neonatal resuscitation, stillbirth, post-partum haemorrhage, severe diarrhoea and maternal death. Proportions were compared using Fisher's exact test. Of 612 women with a gestation of more than 40 weeks, 205 received castor oil for induction and 407 did not. The time to birth was not significantly different between the two groups (hazard ratio 0.99 (95% confidence interval: 0.81 to 1.20; n = 509)). Castor oil use was not associated with any harmful effects on the mother or fetus. Castor oil for induction of labour had no effect on time to birth nor were there any harmful effects observed in this large series. Our findings leave no justification for recommending castor oil for this purpose.Australian and New Zealand Journal of Obstetrics and Gynaecology 10/2009; 49(5):499-503. · 1.24 Impact Factor
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2009
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Shoklo Malaria Research Unit
Mae Sot, Changwat Tak, Thailand
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