Nowadays, more and more women embark on pregnancy with previous Caesarean scar. One in five pregnancies requires induction of labour. The use of non-pharmacological methods (methods without using medication) has been gaining popularity for women who are not good candidates, such as women with previous Caesarean scar, for induction with medications such as prostaglandin. Labour induction with prostaglandin carries a higher risk of uterine rupture and thus it is not routinely offered to women with previous Caesarean delivery in Cairo University Hospital. Non-pharmacological methods of induction of labour appear to be safe in women with previous Caesarean delivery. However, various methods are available and the efficacy among them remain in doubt.
In Cairo University Hospital, castor oil, which is a type of induction methods, is routinely offered to women with previous Caesarean delivery who require induction of labor. However, castor oil may not exert its labor induction effect immediately and the delivery may be delayed by up to 8 days. This may render a proportion of women resort to repeated Caesarean section for failed induction. Castor oil is traditionally given by midwives in order to induce labor. The investigators are intent to recruit 70 healthy pregnant women with a history of previous one cesarean section and with no contraindication to trial of labor after cesarean . Women will be randomly and blindly divided into equal-sized intervention group and control group. Intervention group will be given a single dose 60 mL of castor oil in 140 mL of orange juice, while control group will be given a placebo with similar texture. Primary outcomes to be tested are the percentage of women entering active labor within 24 hours of castor oil or placebo administration and the number of successful vaginal deliveries after cesarean.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
70
The intervention group will be given 60 mL of castor oil in 140 mL of orange juice
the control group will be given a sunflower oil as a placebo with a similar texture to castor oil
faculty of medicine Cairo university
Cairo, Egypt
Percentage of women entering active phase within 24 hours of administering castor oil/placebo
Actual time of delivery
Time frame: two weeks
number of successful VBAC cases
number of successful cases who delivered vaginally
Time frame: 24 hours
Neonatal apgar scores
Neonatal APGAR scores
Time frame: 1 minute and 5 minute after delivery
Neonatal complications including hospitalization in NICU
Were there any admissions to NICU, what was the reason ?
Time frame: immediately after birth
Mode of delivery (ie. Normal delivery Vs. Cesarean delivery)
Mode of delivery
Time frame: Within two weeks of enrollment
duration of labor
duration of labor in hours
Time frame: 24 hours
number of cases needing oxytocin augmentation
number of cases needing oxytocin augmentation
Time frame: 24 hours
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