Efficacy of Castor Oil as Labor Inducing Agent and its Fetomaternal Outcome in Tertiary Care Centre

Background: Labor is a fastidious journey and secret of its successful culmination depend on coordination between contracting uterus and ripening cervix.Induction of labor is an obstetric procedure, designed to pre-attempt the natural process of labor by initiating its onset artificially, before this occurs spontaneously.Castor oil is an herbal preparation that has been used for induction of labor from ancient Egypt until now, but it has not achieved destined popularity.Castor oil is a vegetable oil, pressed from castor beans.Castor oil is an effective agent for induction of labor and cervical ripening at term, when compared to other methods of labor induction.Objective: Our study is being carried out to assess the efficacy of castor oil as a labor inducing agent and its fetomaternal outcome in tertiary care Centre. Materialand methods: It was a descriptive study carried out atumaid hospital, Dr.S. N. medical college, Jodhpur, a tertiary care hospital in Rajasthan from month of May 2020 to July 2020.All women with 37 completed weeks gestation with single live fetus in cephalic presentation with a Bishops score <6 and a reactive nonstress test were included in the study. Results: A total of 200 patients were studied, HDOP (35.7%) was the most common indication for induction of laborin primigravida using castor oil followed by postdated pregnancy (25.2%). In multigravida postdated pregnancy (28.5%) was the most common indication for induction of labor in using castor oil followed by oligohydromnios (26.6%). Out of 105 multigravidas 90(85%) were successfully induced with castor oil. Among primigravida 54(56.8%) out of 95 were successfully induced, so castor oil is more effective in multigravida as an inducing agent for labor.Active Labor initiation in castor oil administered women (both primigravida and multigravida) was 60%. In successfully induced group 90.2% women delivered vaginally and 9.7% underwent caesarean section. In successfully not induced group 46%women delivered vaginally and 53.5% women underwent caesarean section.32(16%) women had meconium stained liquor and 168(84%) women had clear liquor. Oxytocin augmentation was required in 69.4% in primigravida and 38% in multigravida.Need of additional method i.e. diniprostone gel and oxytocin was required in 61% in primigravida and 20.9% in multigravida.Most common side effects seen in mother was nausea (15%) followed by diarrhea (12.5%) and vomiting (10%). There were no side effects in majority (62.5%) of the women.No. of babies mother shifted were majority (94%) and only 6% were admitted in NICU. Conclusion: Castor oil is safe and effective agent for cervical ripening and labor induction. Castor oil induction is an easy and cost effective method when compared to other inducing agent.Induction delivery interval, requirement for oxytocin augmentation is less in castor oil users. Vaginal delivery rate is high in those who use castor oil as labor inducing agent. So, castor oil is safe, efficient and cost effective. Inducing agent with few maternal and fetal side effects which may become first choice for induction of labor in the coming years.