Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial

Background: Drotaverine, a spasmolytic, has been found to have potential to achieve a reduction in the duration of labor and prevent prolonged labor. Objective: To compare the effects of intravenous drotaverine hydrochloride with placebo for shortening the duration of active phase of labor in primigravida's. Methods: A double-blind, placebo-controlled randomized trial of 246 primigravida's in active phase of labor at term was conducted. They were randomly (1:1 ratio) administered intravenous 2 ml (40mg) of drotaverine hydrochloride or 2 ml of Vitamin B complex as placebo. The primary outcome measure was the duration of active phase of labor. The secondary outcome measures were cervical dilatation rate, oxytocin augmentation rate, incidence of prolonged labor, labor pain scores, mode of delivery, maternal and neonatal outcomes. Results: The mean duration of active phase of labor (hour) was significantly lower in the drotaverine group compared to the control (drotaverine; 6.22 ± 2.41 vs placebo; 8.33 ± 3.56; p <0.001). Also, the cervical dilatation rate (cm/hr) was significantly faster in the drotaverine arm (drotaverine; 1.68 ± 1.02 versus placebo; 1.06 ± 0.53, p <0.001). There was a significantly higher probability of faster delivery among women who were given drotaverine (log-rank test, p < 0.001). The oxytocin augmentation rate, incidence of prolonged labor, labor pain scores, mode of delivery, maternal and neonatal outcomes were not significantly different among the groups. Conclusions: Drotaverine hydrochloride is effective in shortening the duration of active phase of labor without adverse maternal and neonatal outcomes. However, more evidence is needed to explore its role in active phase of labor among primigravid women. Trial registration number: PACTR201810902005232

Protocatechuic acid and saponin mixture from Steganotaenia araliacea stem bark

Steganotaenia araliacea Hochst (Apiaceae / Umbelliferae) is used in East and West African ethnomedicine for treating gastro-intestinal disorders; peptic ulcer; rheumatism and various diseases of microbial origin. The plant was therefore investigated for its chemical constituents while testing for possible antimicrobial; antioxidant; spasmolytic and anti-inflammatory activities. Through bioactivity-driven fractionation; protocatechuic acid was isolated from the ethyl acetate fraction as the main antimicrobial (agar diffusion) and antioxidant (radical scavenging-DPPH) principle. The crude extract exhibited spasmolytic activity; which was found to reside exclusively in the aqueous fraction. Further fractionation of the aqueous fraction yielded a saponin mixture. The observed spasmolytic effect was found to be antihistaminic rather than anticholinergic. The saponin mixture also demonstrated significant anti-inflammatory activity. At a dose of 1 mg/kg i.p. it gave a 77.7 inhibition of carrageenan-induced rat-paw oedema