Discussion
PROM, postdated
MUSCLE RELAXATION, UTERUS
In the present study, there was no statistically significant difference between the 2 groups regarding age, BMI, gestational age, or Bishop score in all induced ladies. The most common indication of induction in the present study was postdated pregnancy, followed by PROM. Our study found that adding propranolol to misoprostol during induction of labor results in a significantly shorter induction-delivery interval and a significantly shorter latent phase of labor when compared to misoprostol alone. Adding propranolol ended in fewer cesarean sections, yet this difference failed to reach statistical significance, with no significant differences regarding indications for cesarean section. The rate of CS in the present study was 29.7% which is lower than higher rates in Egypt which reached 54% of total deliveries. Our hospital is the biggest tertiary university hospital in Cairo governorate with more than 20,000 deliveries per year. Patients who received propranolol did not require significantly lower doses of misoprostol for induction or oxytocin for augmentation of labor. There was no significant difference in neonatal outcome between those who received propranolol with oxytocin and those who received oxytocin only.The beta-2 adrenergic receptor, a member of the family of G protein-coupled receptors is widely expressed in the uterus. Activation of this receptor is important in smooth muscle relaxation resulting from signaling the adenylate cyclase pathway. Propranolol is a β-adrenergic receptor–blocking agent that has been shown and demonstrated to increase uterine activity among pregnant females acting by withdrawing the suppressive impact of the β-agonist isoproterenol on uterine motility in humans [