Duration of Labor
Conditions
Brief summary
Labour is usually physiologic, spontaneous and progressive, but occasionally, there may be the need for induction or augmentation of labour especially in nulliparous women, who are at increased risk of dysfunctional labour. Oxytocin traditionally has been used for induction and augmentation of labour however prolonged labour continued to occur with attendant sequelae. Newer agents like propranolol, with minimal to no maternal and fetal adverse effects in labour have been shown to decreases the duration of labour when used in synergy with oxytocin. However, the paucity of information on the use of propranolol in labour.
Detailed description
ABSTRACT Background: Labour is usually physiologic, spontaneous and progressive, but occasionally, there may be the need for induction or augmentation of labour especially in nulliparous women, who are at increased risk of dysfunctional labour. Oxytocin traditionally has been used for induction and augmentation of labour however prolonged labour continued to occur with attendant sequelae. Newer agents like propranolol, with minimal to no maternal and fetal adverse effects in labour have been shown to decreases the duration of labour when used in synergy with oxytocin. However, the paucity of information on the use of propranolol in labour. Methodology: This research was a superiority open labelled randomized controlled trial that involved only nulliparous women who met the inclusion criteria and gave consent to the study. There was daily recruitment of participants. Randomization was by utilizing computer-generated numbers from a pool of 110 participants divided into A and B. Group A received 20 mg of oral propranolol before initiation of oxytocin titration. Group B received only oxytocin titration. Partograph was used to monitor their labour. Analysis: Absolute and relative frequencies of categorical variables, mean, range and standard deviation of continuous variables were calculated. Continuous variables were analyzed using students t-test while chi-square (χ2) test was used for categorical variables. A P-value of \<0.05 was considered significant. Keywords: Propranolol, Labour, Induction, Augmentation, Nullipara
Interventions
DRUG20mg oral propranolol and oxytocin
Participants will receive 20mg of oral propranolol 10minutes prior to initiation of augmentation or induction of labor with oxytocin
DRUGOxytocin only
Participants will have outright augmentation or induction of labor with oxytocin
Sponsors
Darlington-Peter Chibuzor Ugoji
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
clinical superiority open-labeled randomized controlled trial
Eligibility
Sex/Gender
FEMALE
Age
16 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
1. Nulliparous women selected for induction or augmentation of labour 2. Term pregnancy selected for induction or augmentation of labour 3. Normal singleton pregnancies with cephalic presenting foetuses. 4. Those who gave their consent.
Exclusion criteria
1. Co-existing medical illnesses such as diabetes mellitus, cardiac disease, haemoglobinopathies, renal diseases, hypertensive disease, Bronchial asthma, 2. Women currently taking Propranolol or a chronic beta-blocker use 3. Contraindications to labour or vaginal delivery 4. Multiple gestations 5. Preterm labour 6. Chorioamnionitis 7. Known fetal anomalies 8. Abnormal fetal presentation. 9. Antepartum haemorrhage. 10. Contraindication to induction and augmentation of labour 11. Multi-party 12. Known allergy to propranolol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Induction/Augmentation delivery intervals at delivery | Time frame in minutes from the onset of initiation of Oxytocin to the delivery of the placenta | Labor acceleration at delivery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maternal Blood pressure change in mmgh | Change over 30 minutes | Maternal Blood pressure is checked prior to initiation of oxytocin and 30 minutes after initiation of oxytocin. the difference is noted |
| Fetal heart rate change in seconds | Change over 30 minutes | Fetal heart rate is checked prior to initiation of oxytocin and 30 minutes after initiation of oxytocin. the difference is noted |
Countries
Nigeria
Outcome results
None listed