Supervisors info:
Βλάχος Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Μαστοράκος Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πανουλής Κωνσταντίνος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Objective: To evaluate the effectiveness of the administration of Hyoscine Butylbromide (HBB) for shortening the active phase of first stage of labor and study the effect of the drug on the second stage of labor, the total duration of labor, first and second stage of labor and the cervical dilatation rate.
Methods: This is a systematic review and meta-analysis of randomized controlled trials comparing the administration of HBB at the active phase of first stage of labor to placebo/no treatment in women with single cephalic term pregnancies in labor. Digital libraries, congresses abstracts and references of articles searched from their inception until 31st March 2019. The primary outcome was the duration of the first stage of labor. After critical assessment of the studies for risk of bias, data extracted from studies and Mean Differences (95% CI) were calculated.
Results: Seventeen studies involving 2761 patients were included. A meta-analysis including data for these studies showed that the administration of HBB during the active phase of first stage of labor significantly reduced the duration of first stage of labor (MD -61.46 minutes, 95% CI -85.83, -37.1, p<0.001, I2=95%). Furthermore the administration of HBB was associated with a significant reduction in the duration of the second stage of labor (MD -2.49 minutes, 95%CI -3.99 to -0.98, p=0.001, I2=76%), the total duration of labor (MD -96.45 minutes, 95%CI -192.14 to -0.77, p=0.05, I2=93%), the time from the administration of the drug until the delivery of the fetus (MD -57.11 minutes, 95%CI -94.99 to -19.22, p=0.003, I2=73%) and a significant increase of the cervical dilatation rate (MD 0.57 cm/hour, 95%CI 0.15 to 1.00, p=0.008, I2=89%). No significant adverse effects noted.
Conclusion: It seems that the administration of HBB is effective in shortening the duration of the first stage of labor in single term vertex cephalic pregnancies and safe for both fetus and mother.
