A randomized controlled trial of valethamate bromide in acceleration of labor. Effect of hyoscine butylbromide first stage of labour in multiparus women. Meperidine versus valethamate bromide in shortening the duration of active labor. A randomised controlled study comparing Drotaverine hydrochloride and Valethamate bromide in the augmentation of labour. The effect of hyoscine butylbromide on the first stage of labour in term pregnancies. Drotaverine hydrochloride vs. valethamate bromide in acceleration of labor. Use of an antispasmodic (rociverine) to shorten the length of labor: a randomized, placebo-controlled trial. Drotaverine hydrochloride versus hyoscine-N-butylbromide in augmentation of labor. Drotaverine hydrochloride for augmentation of labor.
A randomized controlled study of valethamate bromide administered by intramuscular injection in acceleration of labor was done in 60 consecutive primigravidae and 60 consecutive multigravidae admitted in labor at 2-4 cm cervical dilatation. There was no difference observed in the rate of cervical dilatation between those who received valethamate bromide and those who received normal saline. However, maternal tachycardia was observed in significantly more women primigravida RR 1.97, 95% CI 1.3-3.0; multigravida RR 2.16, 95% CI 1.3-3.6) who had received valethamate bromide. Prolonged labor is one of the most important risk factors for perinatal compromise and, if caused by obstructed labor, it carries the risk of uterine rupture, postpartum hemorrhage (PPH), puerperal sepsis, and maternal death.
                To determine whether or not hyoscine butylbromide shortens the stages of labor, without an increase in maternal or neonatal complications.
                In single-blinded randomized clinical trial study, 188 multiparas women in active phase of labor who were admitted to Shahid Sadoughi Hospital from October 2006 to April 2007 in Yazd - Iran, were evaluated. They were divided hyoscine group (n = 94) received 20mg (1ml) of hyoscine and control group (n = 94) received 1 ml of normal saline was given as placebo, intravenously. The effects of hyoscine in shortening labor time; and neonatal Apgar score was compared.
                Duration of the first (mean± SD: 186.8 ± 125.6 minutes vs. 260.4 ± 120.9 minutes, p= 0.00 1) and second stage of labor (mean± SD: 20.0 ± 8.1minutes vs. 25.8 ± 9.4 minutes, p= 0.03) was shorter in hyoscine group. Frequency of cesarean section and mean of neonatal Apgar score at minutes of one and 5 were not different in both groups. No serious adverse events were seen in the two groups.
                Injection of hyoscine in active phase of labor can be effective in shortening of labor without any adverse effect on mother and fetus. To compare the efficacy and safety of meperidine hydrochloride and valethamate bromide against placebo in shortening the duration of active labor.
                We randomly assigned 160 nulliparous women with a singleton pregnancy at term who needed induction of labor to one of 3 treatments: 50 mg of meperidine (n=53), 16 mg of valethamate bromide (n=53), or a normal saline solution as placebo (n=54). All medications were given by slow intravenous infusion. Labor duration was the main outcome measure.
                The intervals between infusion and complete cervical dilation and between infusion and delivery were significantly reduced (P<0.001 and P<0.01) in the meperidine group (103.0+/-64.5 minutes and 119.8+/-70.2 minutes), in contrast to the placebo group (173.9+/-74.8 minutes and 192.2+/-82.8 minutes). However, differences were not significant between the 2 treatment groups (139.6+/-63.1 minutes and 160.6+/-71.9 minutes), or between the valethamate bromide and the placebo group.
                Meperidine, but not valethamate bromide, significantly shortened the duration of active labor in nulliparous women with a singleton pregnancy at term. Cervical dilatation is a poorly understood process. Various drugs have been used to facilitate this process and reduce the duration of labour and thereby reduce feto-maternal complications. The present study is an attempt to compare and evaluate the efficacy of Drotaverine hydrochloride and Valethamate bromide in the process of cervical dilatation and labour augmentation.
                A prospective randomised trial of 146 low-risk women in spontaneous labour was conducted. 49 women were given Drotaverine (Group 1), 49 women were given Valethamate (Group 2) and 48 women were given placebo (Group 3). At 4 cm of cervical dilatation, elective amniotomy was done and the injection was given intramuscularly, and repeated every hour for a maximum of three doses.
                There was a statistically significant difference in the mean injection-delivery times (time from first injection to delivery of the baby), which was 183.2 min (SD 78.8) in the Drotaverine group compared to 206.5 min (SD 69.7) in the Valethamate group, and 245 min (SD 70.9) in the control group. The mean cervical dilatation rate (cm/h) was 3 (SD 1.4), 2.4 (SD 0.9) and 1.9 (SD 0.6) in groups 1, 2 and 3, respectively, and these differences were statistically significant. There were no statistically significant differences in the duration of second and third stage of labour. Transient side effects such as foeto-maternal tachycardia, flushing of the face and dryness of mouth were noted with Valethamate. A few patients complained of headache in the Drotaverine group.
                Both Drotaverine and Valethamate appear to significantly help cervical dilatation and augment first stage of labour. But, Drotaverine is superior to Valethamate with fewer side effects. To determine whether hyoscine butylbromide shortens the first stage of labour, without an increase in maternal or neonatal complications.
                Randomised, double-blinded, controlled trial.
                The Antenatal clinics and Labour and Delivery ward of the University Hospital of the West Indies, Kingston, Jamaica.
                Women in spontaneous labour at term.
                Either drug or placebo was given intravenously once the women entered active labour.
                The duration of the first stage of labour. Secondary outcomes included comparisons of the duration of the second and third stages of labour, blood loss at delivery, rate of caesarean section, and APGAR scores in the neonates between the two groups.
                A total of 129 women yielded data for analysis. Of these, 69 women received the placebo and 60 received hyoscine butylbromide. The mean time for the first stage in the control group was 228 minutes, compared with 156 minutes in the drug group, representing a decrease of 31.7% (P = 0.001). There was no significant change in the duration of the second and third stages of labour, and no difference in blood loss or in APGAR scores. There was a slight (but statistically insignificant) increase in the caesarean section rate.
                Hyoscine butylbromide is effective in significantly reducing the duration of the first stage of labour, and it is not associated with any obvious adverse outcomes in mother or neonate. To compare the efficacy and safety of drotaverine hydrochloride and valethamate bromide in shortening the duration of labor.
                In a randomized controlled trial of 150 nulliparous women in established labor with cervical dilation of 4 cm, 50 women were given drotaverine (group I), 50 women were given valethamate (group II) and another 50 women were not given any medication (group III). Duration of labor, mode of delivery, side effects, and neonatal outcome were measured in all cases. Appropriate non-parametric tests and chi(2) tests were used for assessment of statistical significance.
                In the three groups, 100%, 96% and 46% women delivered within 6 h, respectively. The injection-to-delivery interval was significantly reduced in the drotaverine group (193.96 min) in contrast to the valethamate group (220.68 min) and control group (412.84 min). The rate of cervical dilation was highest in the drotaverine group (2.04 cm/h) compared with the valethamate bromide group (1.86 cm/h) and control group (1.01 cm/h). There were no major maternal or fetal adverse effects in any group, but minor side effects were more common in the valethamate group.
                Both intramuscular drotaverine hydrochloride and valethamate bromide are effective in acceleration of labor; however, drotaverine accelerates labor more rapidly and is associated with less side effects. To determine the effectiveness of rociverine, an antispasmodic drug, for reducing the duration of labor among nulliparous women managed according to a standard intrapartum protocol.
                Randomized controlled trial.
                An academic tertiary care hospital.
                Nulliparae in spontaneous active labor, with cervical dilatation between 3 and 5 cm.
                Participants were randomly assigned to receive either an intramuscular injection of 20mg rociverine (n=55) or the same volume of saline (n=56).
                Cervical dilatation rate (from administration of study drug to full dilatation).
                Laboring women who received rociverine had faster cervical dilatation than those assigned to placebo (2.43 ± 1.84 vs. 1.85 ± 1.38 cm/hour, p=0.03). The time interval from treatment administration to full cervical dilatation was shorter in the rociverine group than in the placebo group (220 ± 125 vs. 278 ± 129 min, p=0.04). No difference was found in any other obstetric outcome. No adverse effects have been recorded from rociverine administration.
                Intrapartum administration of rociverine to nulliparous women may help to reduce the duration of the first stage of labor in a context of uniform labor management.
                © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology. To study and compare the efficacy and side effects of drotaverine hydrochloride and hyoscine-N-butylbromide in the augmentation of labor.
                A prospective randomized trial of 150 women in active labor included 50 women given drotaverine (group 1), 50 women given hyoscine-N-butylbromide (group 2), and 50 women given no medication (group 3). Duration of labor, rate of cervical dilation, mode of delivery, side effects, and neonatal outcome were compared among the groups.
                The mean duration of the active phase of labor was 4.48+/-2.26 h, 3.9+/-2.42 h, and 3.6+/-2.07 h in groups 1, 2, and 3, respectively. The mean rate of cervical dilation was 2.6 cm/h, 2.4 cm/h, and 2.5 cm/h, respectively. The differences were not statistically significant. There was no difference in the duration of the second and third stages of labor. No adverse maternal or fetal outcomes were noted.
                Drotaverine hydrochloride and hyoscine-N-butylbromide do not have a role in augmentation of labor. To study the use of drotaverine hydrochloride for acceleration of labor and relief of labor pains.
                In this double-blind placebo-controlled randomized study, 100 primigravidas in uncomplicated spontaneous labor at term were given drotaverine hydrochloride or placebo (distilled water) intramuscularly. Labor events, including pain (assessed by a visual analog scale and a verbal rating scale), neonatal outcome, and side effects of the drug were recorded. Student's t-test was used for analysis.
                Forty-four patients in the drug group and 40 in the placebo group had complete data for analysis after decoding. In drotaverine group, there was a mean 15% reduction in the duration of the first stage of labor and a mean 19% reduction in the second stage. The maximum shortening of the first stage (28%) was observed when drotaverine was administered when cervical dilatation was 4 cm (P=0.044). There were no adverse fetal effects, but atonic postpartum hemorrhage was more common in the drotaverine group. There was no relief of pain with the drug except in the fourth stage of labor.
                Drotaverine hydrochloride is safe and effective in accelerating labor, but not effective in lessening labor pain.
There is low quality evidence that antispasmodics reduce the duration of first stage of labour and increase the cervical dilatation rate. There is very low quality evidence that antispasmodics reduce the total duration of labour. There is moderate quality evidence that antispasmodics do not affect the rate of normal vertex deliveries. There is insufficient evidence to make any conclusions regarding the safety of these drugs for both mother and baby. Large, rigorous randomised controlled trials are needed to evaluate the effect of antispasmodics on prolonged labour and to evaluate their effect on labour in a context of expectant management of labour.