Effects of phloroglucinol on the active phase of labour (EPAL trial): a single blinded randomised controlled trial in a tertiary hospital in sub-Sahara Africa

Background With the development of China’s two-child-policy, vaginal birth after cesarean section (VBAC) has aroused public concern. It is important to understand the labour characteristics and intrapartum management of women attempting VBAC to enhance the rates of successful VBAC. The purpose of our research was to investigate the differences in the characteristics of labor, intervention measures and perinatal outcomes between women who had a VBAC and primiparas or multiparas not undergoing VBAC, providing clinical references of intrapartum management for women who are planning a VBAC. Material and methods This observational retrospective study enrolled all women who laboured spontaneously and who had a VBAC (n = 139) at the Second Affiliated Hospital of Wenzhou Medical University in China between 2016 and 2019. They were allocated into VBAC group A (the previous cesarean section was performed before dilation of the cervix) and VBAC group B (the previous cesarean section was performed after dilation of the cervix). The primipara control group included 149 primiparae, and the multipara control group included 155 multiparae with second vaginal birth. Durations of labor, intervention measures and perinatal outcomes were compared among the groups. Results The durations of labor, intrapartum interventions and maternal and neonatal outcomes in VBAC group A were similar to those of the VBAC group B. However, all women who had a VBAC and those in VBAC group A had shorter first, second and the total stages of labor than primiparae. All women with VBAC and those in VBAC group B had longer second stage of labor, but shorter third stage of labor than multiparae. Oxytocin, labor analgesia and artificial rupture of membranes were administered less often in women with VBAC than in primiparae, while phloroglucinol was administered more often in women with VBAC than in multiparae. Women who had a VBAC were more likely to receive episiotomy and had higher incidences of postpartum hemorrhage than primipara and multipara women. Conclusions Labor characteristics, intrapartum interventions and perinatal outcomes in women who had a VBAC with cervical dilation were similar to those in women who had a VBAC without cervical dilation before the previous cesarean section, but differed significantly from those of multiparae and primiparae who did not undergo VBAC.

show abstract

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

Lan

Pan

Chen

et al. 2022

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

Effect of Intravenous Phloroglucinol Injections upon duration of Active First Stage of Labor

et al. 2024

View full text Add to dashboard Cite

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics & Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A & Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.

show abstract

Efficacy of Phloroglucinol vs Drotaverine Hydrochloride in Shortening in Primigravidae at Term the Active Phase of the First Stage of Labor

Shahid

Arif

Hamid

et al. 2022

PBMJ

View full text Add to dashboard Cite

Primigravida women are those who conceive for the first time and are at high risk group for complications during childbirth Objective: To compare the effectiveness of phloroglucinol i/v and drotaverine hydrochloride by measurement of the 1st stage of labor in primigravidae. Methods: This randomized controlled trial was held in the Obstetrics and Gynecology Department of Allama Iqbal Memorial Teaching Hospital Sialkot and The Indus hospital QF-NST Campus Lahore for six-months duration from July to December 2021. Several factors were used to determine the inclusion of primigravida females, including age range of 20- 35 years, 38-42 weeks of gestational age at LMP with single pregnancy, Uterine contractions up to 3 cm if they occur at 3-4, 10 minutes before both drugs are given, ROM, no signs of fetal and maternal distress, patient in the first stage of labour. All of the cases were divided into two groups: A and B. Group 'A' received phloroglucinol 40mg (4ml) i/v at 4 cm dilation, and the dosage was repetitive at 8 cm dilation. At 4cm dilation, Group 'B' received drotaverine 40mg i/v. The essential signs including uterine contractions and fetal heart rate were monitored every half an hour. Results: 80 patients were included, with 56.3% of cases in Group-A group B has 43.7% cases being between the ages of 20-35 years. There was a significant improvement in the first stage of active labour ’mean duration in Groups A and B is 160.21±4.29 minutes and 203.77±8.21 minutes, respectively. Conclusion: The mean active length of the 1st stage of labour in the group of phloroglucinol was substantially shorter than in the drotaverine group

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Effects of phloroglucinol on the active phase of labour (EPAL trial): a single blinded randomised controlled trial in a tertiary hospital in sub-Sahara Africa

Cited by 3 publications

References 15 publications

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section

Effect of Intravenous Phloroglucinol Injections upon duration of Active First Stage of Labor

Efficacy of Phloroglucinol vs Drotaverine Hydrochloride in Shortening in Primigravidae at Term the Active Phase of the First Stage of Labor

Contact Info

Product

Resources

About