Valethamate bromide: Conflicting evidence and continuing use

Abstract

We read the editorial 'Valethamate bromide: Is there any proof of efficacy and safety for its use in labour?' by author Gitanjali B, with interest. [1] The editorial excellently describes the inadequate literature and unconvincing evidence regarding the use of valethamate bromide for cervical ripening and dilatation in labor. However, with due respect to the author, we would like to raise certain points. Firstly, we feel that the article is more biased and judgmental rather than being open to all currently available evidence. Contradictory to what is stated in the article, many clinical trials have shown that valethamate bromide is effective in facilitating cervical ripening, dilatation and thereby decreasing the duration of labor. [2][3][4][5] But, the effect is not seen consistently and two trials have found no significant effect with the use of this drug. [6,7] We also wish to differ regarding the first of the three reasons suggested by the author for using this drug, which states 'that it is beneficial in crowded labor rooms to facilitate the reduction in time spent monitoring patient rather than a sound medical reason'. The most important reason for using this drug is to facilitate the labor process and reducing labor duration with an ultimate aim of reducing fetomaternal complications secondary to delayed or nonprogressive labor.

Accessibility and potency of uterotonic drugs purchased by simulated clients in four districts in India

“…Valethamate bromide is not a uterotonic drug. It is a smooth muscle relaxant which is commonly used in India to relax the cervix and hasten delivery [ 26 , 27 ]. Here we refer to it as a uterotonic.…”