WHO monographs on selected medicinal plants - travolekar.ru

<strong>WHO</strong> <strong>monographs</strong> on selected medicinal plants
Induction of labour
Castor oil has been widely used as a traditional method of initiating labour
in midwifery practice. Its role in the initiation of labour is poorly
understood and data examining its clinical efficacy are severely limited.
The effects of castor oil administered orally or in enemas for third trimester
cervical ripening or induction of labour in comparison with other
methods of cervical ripening or induction of labour have been reviewed.
One prospective study of 100 women compared a single dose of castor
oil with no treatment. The pregnant women had intact membranes at 40–
42 weeks of gestation and were referred for antepartum testing. Inclusion
criteria included cervical examination, a Bishop score of 4 or less, and no
evidence of regular uterine contractions. Patients were alternately assigned
to one of two study groups. One group received a single oral dose
of castor oil (60 ml), and the other, no treatment. Castor oil treatment was
considered successful if labour began within 24 hours after administration.
Groups were compared for onset of labour within 24 hours, method
of delivery, presence of meconium-stained amniotic fluid, and Apgar
score and birth weight of the infant. Fifty-two women received castor oil
and 48 no treatment. Following administration of castor oil, 30 of 52 women
(57.7%) began active labour compared to 2 of 48 (4.2%) who had received
no treatment. Of the women in whom castor-oil treatment was
successful, 83.3% (25/30) of the women delivered vaginally. No difference
was found between rates of caesarean section (relative risk (RR) 2.31;
95% confidence intervals (CI) 0.77–6.87). No data were presented on
neonatal or maternal mortality or morbidity. There was no difference between
either the rate of meconium-stained liquor (RR 0.77; 95% CI 0.25–
2.36) or Apgar score < 7 at 5 minutes (RR 0.92; 95% CI 0.02–45.71) between
the two groups. The number of participants was small, hence only
large differences in outcomes could have been detected. The primary sideeffect
was nausea. In general, because the trial was small and of poor
methodological quality, there is insufficient evidence to support the safety
and efficacy of the oil for the induction of labour (33, 34).
Wound-healing effects
Skin graft donor sites are partial-thickness wounds that are commonly
managed with gauze-type dressings, which often cause more pain and difficulty
in healing than the graft-recipient site. A retrospective study was
conducted to ascertain the effects of using a castor oil-balsam of Perutrypsin-containing
ointment on skin graft donor sites in 36 consecutive
patients (16 female, 20 male). All donor sites were epithelialized after
11 days (range 6–11 days, mean 8 days) and no wound complications were
observed (35).
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