Drotaverine to improve progression of labor among nulliparous women

Ibrahim, Moustafa I.; Alzeeniny, Hazem A.; Ellaithy, Mohamed; Salama, Dina H.; Abdellatif, Mohammed

doi:10.1016/j.ijgo.2013.08.013

Cited by 9 publications

(20 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These medications are commonly used during labor in both developing and developed countries [11]. HBB (also known as scopolamine is an anticholinergic and anti-muscarinic medication that has shown spasmolytic function on the smooth muscle of the female genital tract, especially the cervico-uterine plexus [12,13]. This medication can progresses cervical dilatation without any effect on contractions of the uterus [12].…”

Section: Introductionmentioning

confidence: 99%

The effect of hyoscine n- butylbromide on labor progress: A systematic review

Mohaghegh

Abedi

Faal

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background: The objective of this systematic review and meta-analysis was to assess the effectiveness of hyoscine n-butylbromide in labor progress.Methods: The databases including PubMed, the Cochrane Library, Science-Direct, Scopus and Web of Science were searched for studies published up to December 2019. Articles that published as randomized controlled trials (RCTs), and full-text articles published in English or other languages were included and participants were primi or multigravida women who were in active phase of labor. The intervention included HBB compared to placebo (normal saline) that was used during active phase of labor. Pooled estimates were measured using the fixed or random effect model, while the overall effect was reported in a mean difference (MD). All data were analyzed using Review Manager 5.3. Results: Twenty studies involving 3108 women were included in meta-analysis. Based on subgroup analysis by parity, use of HBB significantly reduced the duration of the first stage of labor in primigravida women (MD = − 57.73; 95% CI: [− 61.48, − 53.60]) and in multigravida women (MD = − 90.74; 95% CI: [− 97.24, − 84.24]). Administering HBB could reduce the second stages of labor in primigravidas and multigravidas about 6 min and 4 min respectively. Also, HBB reduced the duration of the third stage of labor in multigravidas about 3 min. APGAR score at one and 5 min after birth was not affected. The main maternal adverse effect was tachycardia and dry mouth. Labor duration in studies in which the participants were primi-and multigravida was not presented based on separate parities except for four papers, and the route of HBB administration was not the same across all studies. Conclusions:Although, the effect of HBB was minimal when multigravidas and primigravidas women were considered together, the HBB was clinically effective in primigravida and multigravida women for shortening the first and the second stages of labor. Also, HBB could reduce the length of the third stage of labor in multigravidas.

show abstract

Section: Introductionmentioning

confidence: 99%

The effect of hyoscine n- butylbromide on labor progress: A systematic review

Mohaghegh

Abedi

Faal

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…However, the administration of drotaverine during labor is not listed under the manufacturer's indications for its use. Although the drug is commonly used in many countries, there is still not enough research on its safety for mother and child during labor [9][10][11][12]. The results of the meta-analysis revealed no serious adverse events in any of the studies after the administration of drotaverine during labor, although it should be noted that the authors recorded maternal and neonatal adverse events such as tachycardia, headache, nausea, or vomiting in only half the studies that have been conducted on this topic [9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Oral Drotaverine Administration on Materno–Fetal Circulation during the Second and Third Trimester of Pregnancy

2022

View full text Add to dashboard Cite

Background and Objectives: The study aimed to evaluate the effect of the oral administration of drotaverine on maternal and fetal circulation as measured by Doppler sonography in women with a risk of preterm birth. Materials and Methods: The present prospective study was conducted on 34 women with singleton pregnancy at 26–36 weeks of gestation. Doppler flow and pulsatility index (PI) assessments of the umbilical artery, fetal middle cerebral artery, and uterine arteries were performed before and 90–120 min after oral drotaverine administration. Results: There were no statistically significant differences between the Doppler assessment (PI Uma—umbilical artery, MCA—middle cerebral artery, and ltUta—left uterine artery) before drotaverine administration and 90–120 min after oral intake, but there were statistically significant differences between the PI assessment of the rtUta (right uterine artery, 0.55 vs. 0.75, p = 0.05) and the mean of the Uta (0.66 vs. 0.74, p = 0.03). For changes in the CUR (cerebro–umbilical ratio) and % changes in the CUR and mean PI of the Uta, there was no correlation with obstetric history, AFI (amniotic fluid index), gestation week, infertility history, systolic pressure, or diastolic pressure. There was a statistically positive correlation between changes in the CUR and % change in the CUR and body weight and in height. Conclusions: Drotaverine has no statistically significant influence on the MCA and Uma PI. The oral administration of drotaverine has an impact on PI rtUta and the mean PI Uta.

show abstract

“…Contrary, secondary outcomes significantly differed between groups: papaverine exposure was associated with higher rates of preterm deliveries and caesarean sections, which remained significant following adjustment to known risk factors. In light of the several prospective studies showing an augmenting effect of drotaverine on labour and the smooth muscle relaxation effect of papaverine, 6,7 these findings require further attention: subanalyses by indication showed that papaverine exposure was not associated with preterm deliveries among those cases treated for gastrointestinal or urological aetiologies, but remained significant when given for obstetrical reason. Similar trends were also shown for caesarean sections.…”

Section: Discussionmentioning

confidence: 99%

“…The agent was also reported to be effective in reducing blood pressure among pre‐eclamptic patients, as well as to result in better outcomes following intravascular administration in patients with vascular occlusions 3,4 . Drotaverine, an agent structurally related to papaverine, was also demonstrated in small prospective studies to augment the first stage of labour, probably via its relaxing effect on smooth muscle leading to cervical dilation 5,6 . However, data on maternal and foetal safety of these agents is scarce: high‐dose papaverine given to chicken embryos was shown to be associated with increased risk of neural tube malformations 7 .…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes following gestational exposure to papaverine: An observational comparative study

Gueta

Braun

Gilan

et al. 2021

Brit J Clinical Pharma

View full text Add to dashboard Cite

Aims Papaverine is indicated for abdominal pain of various aetiologies. However, data on maternal and foetal safety following gestational exposure are lacking. The aim was to examine whether first trimester exposure to papaverine is associated with increased risk for major malformation and whether gestational exposure at any stage is associated with increased risk for preterm delivery, lower birthweight, small for gestational age, caesarean section (CS), lower Apgar score and perinatal death. Methods A retrospective comparative study consisted of pregnant women treated with papaverine between February 2010 and October 2019 at a large tertiary center. The control group comprised of livebirth deliveries randomly selected from the institutional obstetric database. Results The study group consisted of 498 pregnancies, which resulted in 537/544 (98.7%) live births, of whom 46/537 (8.6%) were exposed during the first trimester. The control group consisted of 498 pregnancies and 514 live births. Rate of major malformations did not differ between study group (2/46, 4.3%) and control (25/315, 4.9%, P = .67). Papaverine exposure was associated with higher rate of preterm delivery (22.3 vs. 10.3%, P < .001), CS (35.9 vs. 24.1%, P < .001) and lower birth weight (3207 vs. 3246 g, P = .02). Adjustment for treatment indication demonstrated that these remained significant only when given for obstetrical/surgical aetiologies. Comparable rates were observed for the remaining outcomes. Conclusions Short‐term gestational exposure to papaverine adjusted for indication was not associated with preterm deliveries, CS, lower birthweight, small for gestational age or perinatal death. Rate of major malformations among 46 first trimester exposures was comparable to controls.

show abstract

Drotaverine to improve progression of labor among nulliparous women

Abstract: Drotaverine hydrochloride was used effectively and safely to shorten the duration of the first stage of labor among nulliparous women with active spontaneous labor. ClinicalTrials.gov: NCT01639027.

Cited by 9 publications

References 15 publications

The effect of hyoscine n- butylbromide on labor progress: A systematic review

The effect of hyoscine n- butylbromide on labor progress: A systematic review

The Influence of Oral Drotaverine Administration on Materno–Fetal Circulation during the Second and Third Trimester of Pregnancy

Pregnancy outcomes following gestational exposure to papaverine: An observational comparative study

Contact Info

Product

Resources

About