Effectiveness of Castor Oil in Preventing Post-term Pregnancy in Low Resource Setting: A Randomized Controlled Trial

Okoro OS^1, , Ugwu EO¹, Dim CC¹, Ozumba BC¹, Nkwo PO¹, Ajah LO¹ and Okeke TC¹

¹Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria

Cite this paper

Okoro OS, Ugwu EO, Dim CC, Ozumba BC, Nkwo PO, Ajah LO and Okeke TC. Effectiveness of Castor Oil in Preventing Post-term Pregnancy in Low Resource Setting: A Randomized Controlled Trial. American Journal of Clinical Medicine Research. 2019; 7(2):37-43. doi: 10.12691/AJCMR-7-2-1

Abstract

Castor oil has long been used as a way of inducing labor and preventing post-term pregnancy. However, its safety and effectiveness has not been conclusive thereby necessitating the need for further studies. This article evaluated the effectiveness of single oral dose of castor oil at 40-41 weeks of gestation for prevention of post-term pregnancy, in a low resource setting. This was a randomized controlled trial of pregnant women attending antenatal care clinic at the University of Nigeria Teaching Hospital Enugu, Nigeria. The eligible participants were randomized into two groups; group A (intervention group) received oral castor oil (60mls) and group B (control group) did not receive castor oil. The intervention group had a lower incidence of post term pregnancy compared to the control group (18/105(17.1%) vs 44/106(41.5%), RR= 0.41, NNT= 4). The proportion of women requiring formal induction of labor with misoprostol or with oxytocin was significantly lower in the intervention group than in the control group (18/105 (17.1%) vs 44/106(41.5%), RR= 0.41, NNT= 4). The intervention group were less likely to have their labor augmented with oxytocin compare to the control 41/87(47.1%) vs 44/62(71.0%), RR 0.66, NNT 4). The route of delivery and the need for new born special care unit admission were similar in the two groups. There was no significant difference in the maternal complications due to castor oil in the two groups. Single oral dose of Castor oil administration significantly lowers the incidence of post- term pregnancy, without higher risk of maternal and/ or neonatal complications.

Keywords

effectiveness, castor oil, preventing, post-term, pregnancy, Enugu, Nigeria

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC, Haweth JC, Wesstrom KD. Williams Obstetrics. C3. 21st Ed. New York: McGraw-Hill; 2001.p 469-479, 729-760
[2]	Dare FO, Oboro VO. The role of membrane stripping in the prevention of post term pregnancy: A randomized controlled trial in Ile-Ife, Nigeria. Int. Obstetric Gynaecol 2002; 22(3): 283-6.
[3]	James DK, Steer PJ, Weiner CP, Gonic B. High risk pregnancy management options. In. Arulkumaran HS, editor, prolonged pregnancy 2nd ed London: WB Sanders; 2000. p. 1057-1066.
[4]	Gabbe SG, Nielyl JR, Simpson JL. Obstetrics normal and problem pregnancies. In. Divia MY: editor, prolonged pregnancy 4th ed. New York: Churchill Livingstone: 2002. p 931-940.
[5]	Scarpa A, Guerci A, Various uses of the castor oil plant (Ricinus communis L). A review. J Ethnopharmacol. 1982; 5: 117-137.
[6]	Saalmuller L. Ueber die fetten sauren des ricinusols. (On the fatty acid of castor oil) Justus Liebigs Ann Chem. 1848:64: 108-126. German.
[7]	Azhari S, Pirdadeh S, Lotfalizadeh M, Shakeri MT. Evaluation of the effect of castor oil on initiating labor in term pregnancy. Saudi Med J. 2006 July 27 (7): 1011-4.
[8]	Garry D, Figueroa R, Guillaume J, Cucco V. Use of castor oil in pregnancies at term. Altern Ther Health Med. 2000: 6: 77-79.
[9]	Boel MEI, Lee SJ, Rijken MJ, Paw MK, Pimanpanarak, Tan SO, Singhasivanon P, Nosten F, McGready R. Castor oil for induction of labor: not harmful, not helpful. Aust N Z J Obstet Gynaecol. 2009 Oct: 49(5):499-403.
[10]	Alkire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy. A survey of North Carolina Certified nurse-midwifes. Obstetrics and Gynecology 2000; 95: 19-23.
[11]	Kirkwood BR. Calculation of required sample size. In: Essentials of Medical Statistics. Blackwell scientific publications 1998; 191-200.
[12]	Luderer JR, De,mers LM, Nomides CT, Hayes AH jr. Mechanism of action of castor oil. A biochemical link to the prostaglandins. Res 1980; 8:1633-1635.
[13]	Davis L. The use of castor oil to initiate labor in patient with premature rupture of membranes. J Nurs midwifery 1984: 29: 366-370.
[14]	Mattie JG, Dewson BH. Effect of castor oil, soap enema and hot bath on the pregnant human uterus near term. A topographic study. Br Med J 1959:46: 1163-1165.
[15]	Mitri F, Hofmeyer GJ, Vangelderen CJ. Meconmium during labor, self medication and other associations. S Afr Med J 1987: 71: 431-433.
[16]	Alkire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy. A survey of North Carolina Certified nurse-midwifes. Obstetrics and Gynecology 2000; 95: 19-23.
[17]	Littleton LY, Engebreston JE. Maternal, Neonatal and women’s health Nursing. 1st ed. Australia: Delnar; 2002 p.517.
[18]	Mcfarlin BL, Gibbson MH, O'Rear j, Harmann P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendation for practices. J Nurs Midwife 1999; 44:205-216.
[19]	Kelly AJ, Kavanagh J, Thomas J, Castor oil, bath and/or enema for cervical priming and induction of labor. Cochrane database, 2012 issue 5.
[20]	Bishop EH. Pelvic scoring for elective induction. Obstet Gynaecol 1964; 24: 266-8.
[21]	Harrison FR, Flynn M, Craft I. Assessment of factors constituting an inducibilty profile. Obstet Gynaecol 1977; 49: 270.
[22]	Divon MY, Haglund B, Nisell H, Otterblad PO, Westgreen M. Fetal and neonatal mortality in the post term pregnancy: the impact of gestational age and fetal growth restriction. AMJ Obstet Gynaecol, 1998; 178(4): 726-3.
[23]	MLA, Life and Health, study shows science daily. Accessed September 28, 2012 from http//:www.sciencedaily.com/released/2008/10/081007091459htm.
[24]	Nabrors GC. Castor oil as an adjuvant to induction of labor re-evaluation. Am J Obstet. Gynaecol. 1985:75:36-38.