A prospective study on effectiveness of drotaverine in acceleration of labor

Dhungana, Padma Raj; Adhikari, Rajesh; Pageni, Prem Raj; Koirala, Apsara; Nepal, Anand

doi:10.3126/mjpahs.v2i3.26108

Cited by 4 publications

(12 citation statements)

References 4 publications

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“…This finding was similar with the results of other studies. 2,8,[14][15][16][17] These findings laid credence to the mechanism of action of drotaverine in accelerating cervical dilatation, its effect being primarily on the cervix and does not affect contractility of the myometrium despite having smooth muscle relaxing effect. In this study, the rate of oxytocin augmentation did not differ in both study arms.…”

Section: Discussionmentioning

confidence: 84%

“…The other studies reviewed did not assess pain, to determine the analgesic property of drotaverine. 8,[14][15][16] Maternal side effects are mild and rare. It usually occurs when the drug is given rapidly during intravenous administration.…”

Section: Discussionmentioning

confidence: 99%

“…7 The contribution of cervical spasm to delay in cervical dilatation and the exact mechanism through which antispasmodics, including drotaverine hydrochloride may hasten cervical dilatation has not been fully elucidated. 8 There is however an increasing pool of evidence suggesting a significant reduction in the duration of the first stage of labour and an increase in cervical dilatation rate for patients who received drotaverine hydrochloride in labour. 2,8 Although the World Health Organisation (WHO) published a weak recommendation based on very low-quality evidence against giving antispasmodics to reduce the duration of labour as they did not consider a 1-hour reduction clinically significant especially with limited safety data, the WHO guideline development group considered studying the use of antispasmodics to treat labour delay a research priority.…”

Section: Introductionmentioning

confidence: 99%

“…8 There is however an increasing pool of evidence suggesting a significant reduction in the duration of the first stage of labour and an increase in cervical dilatation rate for patients who received drotaverine hydrochloride in labour. 2,8 Although the World Health Organisation (WHO) published a weak recommendation based on very low-quality evidence against giving antispasmodics to reduce the duration of labour as they did not consider a 1-hour reduction clinically significant especially with limited safety data, the WHO guideline development group considered studying the use of antispasmodics to treat labour delay a research priority. 9 Apresent, few studies have evaluated the role of drotaverine in labour manage-ment in the background of active management of labour or a standard intrapartum protocol.…”

Section: Introductionmentioning

confidence: 99%

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Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial

Ikeotuonye¹,

Umeora²,

Nwafor³

et al. 2022

Afr H. Sci.

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Background: Drotaverine, a spasmolytic, has been found to have potential to achieve a reduction in the duration of labour and prevent prolonged labour. Objective: To compare the effects of intravenous drotaverine hydrochloride with placebo for shortening the duration of active phase of labour in primigravidas. Methods: A double-blind, placebo-controlled randomized trial of 246 primigravidas in active phase of labour at term was conducted. They were randomly (1:1 ratio) administered intravenous 2 ml (40mg) of drotaverine hydrochloride or 2 ml of Vitamin B complex as placebo. The primary outcome measure was the duration of active phase of labour. The secondary outcome measures were cervical dilatation rate, oxytocin augmentation rate, incidence of prolonged labour, labour pain scores, mode of delivery, maternal and neonatal outcomes. Results: The mean duration of active phase of labour (hour) was significantly lower in the drotaverine group compared to the control (drotaverine; 6.22 ± 2.41 vs placebo; 8.33 ± 3.56; p <0.001). Also, the cervical dilatation rate (cm/hr) was significantly faster in the drotaverine arm (drotaverine; 1.68 ± 1.02 versus placebo; 1.06 ± 0.53, p <0.001). There was a significantly higher probability of faster delivery among women who were given drotaverine (log-rank test, p < 0.001). The oxytocin augmentation rate, incidence of prolonged labour, labour pain scores, mode of delivery, maternal and neonatal outcomes were not significantly different among the groups. Conclusions: Drotaverine hydrochloride is effective in shortening the duration of active phase of labour without adverse maternal and neonatal outcomes. However, more evidence is needed to explore its role in active phase of labour among primigravid women. Trial registration number: PACTR201810902005232. Keywords: Drotaverine; duration of active phase of labour; primigravidas; placebo; shortening.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial

Ikeotuonye¹,

Umeora²,

Nwafor³

et al. 2022

Afr H. Sci.

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“…An ideal labour antispasmodic agent should have a short onset of action, a long duration of action, and no adverse effect on the mother and baby [9]. In search of an ideal labour antispasmodic agent, drotaverine a newer musculotropic antispasmodic has excellent pharmacological properties.…”

Section: Introductionmentioning

confidence: 99%

Cervical dilatation rate following augmentation of dysfunctional labour with oxytocin alone versus oxytocin and drotaverine among term nulliparas in the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Jumbo¹,

Jeremiah²,

Nonye-Enyidah³

et al. 2022

World J. Adv. Res. Rev.

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Background: Dysfunctional labour is the commonest abnormality of the first stage of labour. It complicates 50% of nulliparous deliveries and is associated with increased perinatal morbidity and mortality. Dysfunctional labour occurs when the progress in the active phase of labour is abnormally slow (<1 cm/hr). It is largely due to ineffective uterine contractions or slow cervical dilatation. Augmentation of labour with oxytocin is the standard management of dysfunctional labour as it enhances uterine contractions. In many cases, despite good uterine contractions slow progress persists due to cervical smooth muscle spasms. Drotaverine a smooth muscle relaxant can be used to relieve cervical smooth muscle spasms. Aim/objective: This study compared the cervical dilatation rate in term nulliparas following augmentation of dysfunctional labour with oxytocin versus oxytocin and drotaverine. Methods: The study was a single-blinded randomized clinical trial involving 156 term nulliparous women with dysfunctional labour, who were randomized into two groups. Each group had 78 participants and received either oxytocin with a placebo or oxytocin with drotaverine. They were monitored until delivery and the cervical dilatation rates in both groups were compared. Data obtained were analysed using SPSS version 23 software. The level of significance was set at 0.05. Results: The two groups were similar in their baseline characteristics, the mean pre-intervention cervical dilatation rate were also similar (0.53 cm/hr vs. 0.52 cm/hr, p = 0.85). Following augmentation, the cervical dilatation rate in the oxytocin-drotaverine group was significantly faster than in the oxytocin-placebo group (1.60 cm/hr vs. 1.20 cm/hr, p < 0.01). Conclusion: The use of drotaverine with oxytocin in managing dysfunctional labour in term nulliparous women leads to a faster cervical dilatation rate.

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Prevention of prolonged labour in term nulliparas with oxytocin alone versus with oxytocin and an antispasmodic

Awopola Ibiebelem Jumbo,

Esther Ijeoma Nonye-Enyidah,

Rose Sitonma Iwo-AmahPeacebe Sunday Abere

et al. 2023

Magna Sci. Adv. Res. Rev.

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Background: Poor progress of labour is a common problem with nulliparous deliveries. It occurs when the cervical dilatation rate in the active phase of the first stage of labour is <1cm/hr, and is mainly due to poor uterine contractions or slow cervical dilatation. Without interventions, poor progress could degenerate into prolonged labour which is associated with increased maternal and perinatal morbidity and mortality. Augmentation of labour with oxytocin is the traditional management for poor progress as it enhances uterine contractions. At times, despite adequate uterine contractions poor progress will persist due to cervical smooth muscle spasms. Antispasmodics can relieve smooth muscle spasms. Aim/objective: This study compared the duration of labour in term nulliparous parturients with poor progress following augmentation with oxytocin alone versus with oxytocin and an antispasmodic (drotaverine). Methods: The study was a single-blinded randomized controlled trial involving 156 term nulliparous parturients with poor progress of labour, that were randomized into two groups in eight months. Each group had 78 parturients which were augmented with either oxytocin with placebo or oxytocin with drotaverine. They were monitored until delivery and the duration of labour in both groups after the intervention was compared. Data obtained were analysed using SPSS version 23 software. The level of significance was set at 0.05. Results: The two groups were similar in their sociodemographic characteristics, and the mean pre-intervention duration of labour was also similar (6.02 ±2.04 vs. 6.09± 2.07hr p=0.23). In this study 135(86.5%) parturients had vaginal delivery while 21(13.5%) had emergency caesarean section. Among those who had a vaginal delivery, the mean duration of labour following augmentation was significantly shorter in the oxytocin-drotaverine group than in the oxytocin-placebo group (6.20 ±0.40hrs vs. 6.64±0.34hrs, MD- 26.4minutes, p<0.01). There was no difference in the duration of the second stage of labour in both groups. Conclusion: The use of drotaverine with oxytocin in managing poor progress of labour in term nulliparous women leads to a significantly shorter duration of the first stage of labour than oxytocin alone.

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A prospective study on effectiveness of drotaverine in acceleration of labor

Cited by 4 publications

References 4 publications

Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial

Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial

Cervical dilatation rate following augmentation of dysfunctional labour with oxytocin alone versus oxytocin and drotaverine among term nulliparas in the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Prevention of prolonged labour in term nulliparas with oxytocin alone versus with oxytocin and an antispasmodic

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