The Effect of Hyoscine Butylbromide on Shortening of First and Second Stages of Labor
Condition: Labor
Study type: Interventional
Phase: Phase 2

Summary: 
      The management of normal labor is both an art and a science. For decades, health providers
      have worked to manage labor actively and safely, with the goal of shortening the duration of
      painful labor. Reduction of Cesarean sections and other fetal and maternal complications is
      also an important aspect of labor management.

      The safety of active management of labor has been demonstrated by several prospective
      randomized clinical trials. A shorter duration of labor from admission to delivery has also
      been consistently reported in numerous studies of women treated with the active management
      protocol.Hyoscine butylbromide belongs to the parasympatholytic group of drugs and is a
      semisynthetic derivative of scopolamine. It is an effective antispasmodic drug without the
      untoward side effects of atropine. Hyoscine butylbromide is a quaternary ammonium compound
      and has peripheral anticholinergic action, but no central action as it does not cross the
      blood-brain barrier. Hyoscine butylbromide acts primarily by blocking the transmission of
      neural impulses in the intraneural parasympathetic ganglia of abdominal organs, apparently
      inhibiting cholinergic transmission in the synapses of the abdominal and pelvic
      parasympathetic ganglia, thus relieving spasms in the smooth muscles of gastrointestinal,
      biliary, urinary tract, and female genital organs, especially the cervico-uterine plexus,
      thus aiding cervical dilatation.

      Spasmolytic drugs are frequently employed in delivery rooms to overcome cervical spasms and
      thus reduce the duration of labor.

      Hyoscine butyl bromide has been used to shorten the duration of labor in several hospitals in
      the world. The mechanism by which it acts in the context of labor has not yet been
      elucidated, and evidence of its efficacy has been largely anecdotal.

      Major studies have been carried out to evaluate the effects of the injectable or suppository
      form of Hyoscine butyl bromide on cervical dilatation; a majority of these studies
      demonstrated the efficacy of Hyoscine butyl bromide in augmenting labor. However, a few
      studies showed no effect of Hyoscine Butyl bromide on accelerating labor. In addition, some
      studies also used oxytocin in active management of labor, which would certainly affect the
      duration of labor and increase bias in the results. The specific objectives of this study
      will be to assess whether Hyoscine butyl bromide is effective in hastening cervical
      effacement and dilatation, thus shortening the duration of the first and second stages of
      labor with or without labor augmentation. We also intended to determine whether the use of
      Hyoscine butyl bromide in the first and second stages of labor has any associated increases
      in complications, such as an increase in blood loss or the rate of cesarean deliveries.
    


Intervention name(s): Hyoscine Butyl bromide; Saline
Intervention type(s): Drug; Drug
Intervention MeSH terms: Scopolamine; Bromides; Butylscopolammonium Bromide
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment