Does hyoscine N-butylbromide shorten the active phase in lab
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Prolonged labor occurs when the duration of the latent phase lasts for approximately 20 hours in nulliparous and 14 hours in multiparous women. An increased birth weight, increased maternal age, artificial rupture of the membranes, and labor analgesia tend to increase the labor duration in pregnant women. The objective of the study is to evaluate the therapeutic effect of hyoscine N-butylbromide (HBB) in active phase of labor and its safety to mother and fetus.

In total, 1448 women from 9 RCTs were included in the meta analysis. The HBB group exhibited significantly decreased durations of active phase (MD -61.1min; 95%), the second stage (MD -2.0 min; 95%), and third stage (MD -0.7 min). Intravenous (IV) HBB group and intramuscularly (IM) HBB group were compared to the control group (MD -60.9 min; 95%). No significant differences were observed in the Cesarean section, post-partum hemorrhage, instrumental labor, Apgar scores, or any adverse effects.

In conclusion, Based on the results of the study, researchers concluded that HBB is effective in significantly shortening the duration of the active phase and third stage of labor. It was also associated with a significant reduction of the need for further analgesia. There was, however, no significant difference in the duration of the second stage of labor, the CS rate, PPH or neonatal APGAR scores. There were also no obvious adverse outcomes in terms of either the maternal or fetal reactions attributable to HBB administration in the active phase of labor. Thus, researchers recommend that a single dose intravenous administration of 20 mg HBB during the active phase to a woman undergoing labor augmentation. It is applicable to both primigravida and multigravida without contraindication. The implications are especially important to countries with limited medical resources in hoping to minimize tragedies that may occur during prolonged labor in the active phase.

Source: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/jog.14507?af=R
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