Effect of intramuscular administration of dexamethasone on the duration of labor induction

Abstract

Introduction: induction of labor is a common obstetric procedure which is performed for a variety of medical and nonmedical indications. If the cervix is unfavorable, prior ripening of the cervix makes induction of labor easier and more successful. There are different methods for ripening of the cervix and making it ready for induction. These methods included medical methods such as the administration of prostaglandins and mechanical methods such as extra amniotic saline infusion, traction on the cervix with Foley catheter and laminaria. Aim: The aim of the study is to evaluate the efficacy of intramuscular dexamethazone injection prior to induction in improving progression and duration of labour phases. Subjects and Methods: This study started with 100 Nulliparous Pregnant women who were conducted at the labor wards of Ain-Shams Maternity Hospital. The studied subjects were randomized into two groups ; dexamethasone group (group A) including 50 Nulliparous women (N=50) and control group (group B) including 50 Nulliparous woman (N=50). Results: In this study, the duration of active and second stages decreased without changing the mode of delivery. The study showed no significant statistical differences between the two studied groups regarding fetal heart rate. The duration of second stage in dexamethasone group was shorter than in the control group. Dexamethasone intramuscularly prior to induction significantly shortens duration of normal labor in normal parturient with minimal complications. Conclusion: An intramuscular injection of dexamethasone before labor induction shortens the duration of labor induction by decreasing the interval between the initiation of induction and the beginning of the active phase, duration of active phase and duration of second stage of labor with no observed maternal or neonatal complications. Recommendation: Further research with more patients undertaken for the assessment of the effects of the corticosteroids on the duration of labor on the patients with unfavorable cervix as well as maternal and perinatal morbidity and mortality rate.

Effect of Intravenous Dexamethasone on Induction of Mid-Trimesteric Abortion Randomized Controlled Trial

“…El-Maraghy et al [13] study showed high significant statistical difference in time taken for induction of labor in each group where group A took 3.92 hrs and group B took 6.24 hrs (P < 0.0001).…”

“…They concluded that intravenous dexamethasone reduces the time duration from the induction to the onset of active phase of labor. Also, Elmaraghy et al [13] who conducted a study at labor ward of Ain-Shams University Maternity Hospitals on 100 nulliparous women at gestational age 38-42 weeks who were divided into 2 groups; group A (dexamethasone group) n=50: 8mg (2ml) amp dexamethasone sodium phosphate was administrated intramuscularly at least half an hour and maximally 6 hours before initiation of labor induction. As well as group B (control group) n=50: (2ml) of distilled water was administrated intramuscularly at least half an hour and maximally 6 hours before initiation of labor induction.…”

“…One of the methods proposed for the strengthening and speeding up of the labor process (labor induction) is the use of corticosteroids, although the effects of using these substances in the labor process is not well understood [11] . Moreover, it has been observed that infusion of glucocorticoids into sheep fetuses causes premature birth induction [13] . In studies carried out, corticosteroids have been employed using extra-amniotic and intravenous methods and in some of these studies, both methods have been proved successful [13,14] .…”

“…Moreover, it has been observed that infusion of glucocorticoids into sheep fetuses causes premature birth induction [13] . In studies carried out, corticosteroids have been employed using extra-amniotic and intravenous methods and in some of these studies, both methods have been proved successful [13,14] . These studies have prepared the way for bringing up the role of corticosteroids in the speeding up of labor induction in women [11] .…”

The effect of dexamethasone on labor induction: a systematic review

“…We examined the outcomes of these two groups separately. Among these articles, eight studies were published in Egypt [12,[22][23][24][25][26][27][28], seven in Iran [7,19,20,[29][30][31][32], one in Iraq [18], and one in Israel [21]. All of them had an RCT design with fourteen using placebo and three having no intervention in their control groups.…”