RESUMEN
PURPOSE: The aim of this study is to investigate the safety and efficacy of castor oil to induce labour. MATERIALS AND METHODS: A retrospective observational case control study was conducted over five years. Castor oil was proposed to women referred to the Birth Centre (Castor Oil group (COG)). They were compared to women who chose to be followed by the traditional doctor-led unit (control group (CG)). Castor oil was administered in a 60 ml single dose in 200 ml of warm water. Inclusion criteria were gestational age between 40 and 41 weeks plus premature rupture of membranes between 12 and 18 hours or amniotic fluid index ≤4 or Bishop Score of ≤4 or absence of spontaneous labour over 41 + 4 weeks. RESULTS: Pharmacological induction of labour was required for 18 women in the COG (45%) and 36 in the CG (90%) (p < .001). The mode of delivery differed significantly between groups: women assuming castor oil showed a higher incidence of vaginal delivery, whereas the incidence of caesarean section was lower in the COG, but no statistical significance was reached. CONCLUSIONS: The use of castor oil is related to a higher probability of labour initiation within 24 hours. Castor oil can be considered a safe non-pharmacological method for labour induction.
Asunto(s)
Aceite de Ricino/uso terapéutico , Trabajo de Parto Inducido/métodos , Oxitócicos/uso terapéutico , Adulto , Estudios de Casos y Controles , Maduración Cervical/efectos de los fármacos , Cesárea/estadística & datos numéricos , Femenino , Humanos , Trabajo de Parto Inducido/efectos adversos , Trabajo de Parto Inducido/estadística & datos numéricos , Misoprostol/uso terapéutico , Embarazo , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: In many countries midwives are the primary providers of care for childbearing women. The aim of the present study was to compare the outcomes of childbirth occurring in the birth benter (midwifery-lead) vs. the traditional delivery room organization (doctor-lead) of the Policlinico of Modena Hospital. METHODS: A prospective observational study was conducted over four years. At 35-36th week, women with a single, uneventful pregnancy, being classified at low-risk according to The National Institute for Health and Care Excellence (NICE) guidelines on intrapartum care, were offered to deliver with standard care assistance (SC) in a doctors-led unit or in the Birth Centre (BC). RESULTS: The number of women included was 3156. Overall emergency cesarean sections were lower in BC vs. SC group, and a significant decrease in the rate of augmentation of labor with intravenous oxytocin, in the use of episiotomy and operative deliveries in women of BC were recorded more than in the SC group. More women with intact perineum were present in BC group, while no significant differences in perineal tears was described between groups. CONCLUSIONS: Our results suggest that midwifery care can result in a decrease of medical interventions during labor, namely a reduction of cesarean section and episiotomy rate. Also, the BC remains a valid option for women who satisfy low-risk criteria and wish to give birth in a hospital setting. In Italy the concern to education of all midwives, obstetricians and women at a global level is urgently required, with specific focus on ethics, communication and philosophy of care to enable normalization and humanization of birth.