Combined Effect of Dexamethazone and Hyoscine Butyl bromide on Duration of Labour in Multiparous Women

Abstract

The present study was performed to examine the effects and safety of hyoscine butyl bromide and dexamethasone during the active phase of labour. It carried out in Ain shams hospital. It included 218 pregnant cases, divided randomly into two equal groups; the first (study group) received hyoscine butyl bromine(20mg i.v) with dexamethasone(8mg i.m) and the second (control group) received placebo. The results of the present study revealed that: • In the present study, maternal age, it ranged from 19 to 33 years with a mean age of 27.29±3.32 years and there was no significant difference between study and control groups (27.34±3.28 vs 27.24±3.6 years, respectively). • In the present study, maternal height ranged from maternal ranged from 63 to 77 kilograms with a mean of 71.75±3.65 and finally, BMI ranged from 22.33 to 30.46 with a mean of 26.56 kg/m2; and there was no significant difference between study and control groups as regard height, weight or BMI.

• In the present study, maternal systolic blood pressure at inclusion ranged from 100 to 130 mmHg with a mean of 112.91±6.41 mmHg, while diastolic blood pressure ranged from 60 to 80 mmHg with a mean of 70.68±5.83 mmHg and there was no significant difference between study and control group. • At inclusion, fetal heart rate ranged from 135 to 145 beat/ minute with a mean of 139.16±2.01 b/min; while maternal pulse ranged from 75 to 89 beat /minute with a mean of 80.70±2.89 beat/ minute and there was no significant difference between study and control groups. • In the present study gestational age, it ranged from 38 to 41 weeks, with a mean of 38.96±0.76 weeks; and there was no significant difference between study and control groups (38.90±vs 39.01±0.80 weeks respectively). • In the present study, cervical dilation at inclusion ranged from 3 to 4 cm with a mean of 4±0.3 cm and there was no significant difference between study and control group (4±0.31 vs 4±0.20 cm, respectively). • In present study spontaneous rupture of membranes, it was reported in 110 cases out of 218 cases (50.5%) and there was significant increase of cases with spontaneous rupture in study group when compared to control group (81 cases (74.3%) vs 29 cases (26.6%) respectively). • In the present study, duration of first stage, it ranged from 140 to 250 minutes with a mean of 192.08±31.74 minutes, and there was significant shortening of first stage duration in study group when compared to control group (165.41 ± 17.97 vs 218.76 ± 16.28 minutes, respectively). On the other hand, there was no significant difference between study and control groups as regard to duration of second and third stages of labour. This effect seems to be due to hyoscine butyl bromide and dexamethasone. • In the present study,caesarean delivery, it was reported in 18 cases out of 218 cases (8.3%) and there was non-significant decrease in study group when compared to control group (6.4% vs 10.1% respectively). • In the present study, instrumental delivery, it was reported in 23 cases (10.6%) and there was non-significant decrease in study group when compared to control group (8.3% vs 12.8%, respectively) . • In the present study, amount of blood loss, it ranged from 160 to 510 CC with a mean of 255.36±66.75 CC; and there was slightly significant decrease of blood loss in study group when compared to control group (247.79±56.70 vs 262.93±74.98 CC, respectively). • In the present study,Apgar score at first minutes, it ranged from 5 to 9 with a mean of 7.63±0.91; while Apgar score at 5 minutes ranged from 8 to 10 with a mean of 8.79±0.61; and there was no significant difference between study and control groups at first and fifth minutes. • In present study, an intramuscular injection of dexamethasone alone was found to shorten the duration of labor by decreasing the duration of first stage of labor with no observed maternal or neonatal complications. • In present study, an intravenous injection of buscopan was found to shorten the duration of labor by decreasing the duration of first stage of labor with no observed maternal or neonatal complications.