Study of the effect of Hyoscine- N -Butylbromide shortening the first stage of labor in primigravidae

Abstract

This is a prospective studyconducted atAin ShamsUniversity Hospital, Maternity department, to study the effect and safety of HBBon the duration of the first stage of labor in primigravidae (active phase of first stage labor). The study was done through the period from July 2015 till January 2016. The study was conducted to 138women, 69women received 40mg HBB slowly iv(HBB group), and 69women for received 2 ml saline (placebo group). The inclusion criteria were: term uncomplicated singleton pregnancy in a spontaneous active labor, with cephalic presentation. The patient must be free from any medical disorder associated with pregnancy and free from any obstetric complication. Cases were randomly allocated into two groups: • Control groupreceived two ml of saline for injection (placebo). • HBB group received two ml (40 mg) Hyoscine-n- butylbromide intravenously.

Every patient was subjected to: Complete history taking, general examination of the patients, obstetric abdominal examination and vaginal examination included cervical dilation, effacement and position, state of fetal membranes, presenting part, position of fetal head, color of liquor and pelvic adequacy. A single dose of drug HBB40 mg or placebo by direct slow IV injection. Pelvic examination was performed every one hour. (to detect the progress of labor). If membrane was intact, amniotomy was performed when obtained regular 3 uterine contractions/10 mints. Progress was again assessed at one hour. When contraction is not optimal, oxytocin infusion was started and adjusted until three to four uterine contractions were noted in a ten-minute period and each contraction lasts for 30-45 seconds. The duration of the first stage of labor was determined. It was calculated from the time of cervical dilatation of >3 cm in active labor (Time of administration of study drugs) until a fully dilated cervix was observed upon vaginal examination conducted every hour. The results revealed significant reduction in the time elapsed from injection of the drug to delivery in study HBB group with mean 2.96 hours (177.8 minutes) than in control (placebo) group with mean 4.03 hours (241.6 minutes) (p<0.001). The use of oxytocin is decreased among HBB group in comparison to control group (p value <0.001). These results observed without significant side effects on neonates or mothers and also no significant difference in mode of delivery as 2 womenin HBB group delivered by C.S. and 5 women in control group delivered by C.S.