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Drotaverine to improve progression of labor among nulliparous women
Author(s) -
Ibrahim Moustafa I.,
Alzeeniny Hazem A.,
Ellaithy Mohamed I.,
Salama Ahmed H.,
Abdellatif Mohammed A.
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.08.013
Subject(s) - medicine , placebo , cervical dilation , cervical dilatation , gynecology , randomized controlled trial , adverse effect , obstetrics , anesthesia , pregnancy , surgery , gestation , cervix , alternative medicine , pathology , cancer , biology , genetics
Objective To reevaluate the role of the antispasmodic drug drotaverine in shortening the length of the active first stage of labor among nulliparous women. Methods In a randomized, double‐blind, placebo‐controlled trial, 422 young nulliparous women admitted to Ain‐shams University Maternity Hospital, Cairo, Egypt, in spontaneous labor were initially enrolled between May and December 2012. Drotaverine hydrochloride (40 mg) or placebo was given at the start of the active phase of labor and then repeated every 2 hours (maximum 3 doses). All participants were consistently managed in accordance with the local institutional intrapartum protocol. The primary outcome was the rate of cervical dilation. Results After excluding women who delivered by cesarean, data were analyzed from 320 women. There was a significant difference in post‐treatment labor pain scores, duration of the active phase of labor, and rate of cervical dilatation between the 2 groups ( P < 0.001 for all). There was no difference in maternal adverse effects. Kaplan–Meier survival analysis showed a greater probability of faster delivery among patients treated by drotaverine hydrochloride (log rank test; P < 0.001). Conclusion Drotaverine hydrochloride was used effectively and safely to shorten the duration of the first stage of labor among nulliparous women with active spontaneous labor. ClinicalTrials.gov : NCT01639027.