Study of drotaverine on first stage of labour and pregnancy outcome.

A prospective randomised study of 200 women with spontaneous onset of labour was carried out in 100 women who were given 40mg of drotaverine hydrochloride intravenously at > or = 3cm dilatation of the cervix, the other 100 were taken as control. The effects of the drug on the progress and outcome of labour were noted. The mean durations of active phase of labour in primigravida and multigravida were 148.9 minutes and 99.5 minutes in drotaverine group whereas in control group were 331.6 minutes and 227.9 minutes respectively. It was concluded that drotaverine is highly effective in reducing the duration of active phase of labour by hastening cervical dilatation, more effective when given in more dilated cervix than with less dilatation and more effective in multigravida than in primigravida. There was no interference with uterine contractility and no increase in operative delivery. It reduces the incidence of traumatic postpartum haemorrhage by reducing the incidence of cervical tear. It is a safe drug for the mother as well as for the baby.

Evaluation of the effect of castor oil on initiating labor in term pregnancy

To determine the effect of castor oil on initiating labor in term pregnant women. We conducted this randomized control clinical trial on 47 pregnant women from August 2003 to March 2004 in Mashhad University of Medical Sciences, Iran. There was a significant increase in labor initiation ratio in the castor oil group compared with the control group [54.2% compared with 4.3%, p<0.001]. Also, the mean bishop score in the castor oil group increased from 2.50 +/- 1.29 to 6.79 +/- 3.20 [p<0.001]. The probability of labor initiation increases during the first 24 hours after using castor oil, however, further studies are recommended to improve its efficacy and safety

Phloroglucinol for acceleration of labor: Double blind, randomized controlled trial

To determine the effects of Phloroglucinol in acceleration of labour and its adverse effects on mother and foetus. A double blind randomized, placebo controlled trial was conducted on 100 patients in active phase of uncomplicated labour selected by convenient sampling. Patients were given Phloroglucinol or Placebo [distilled water] intravenously. Progress of labour was plotted on Partogram. Any adverse effects of the drug on mother and fetus were noted. Student's t-test was applied for statistical analysis. In patients receiving Phloroglucinol there was a mean 34% reduction in duration of 1st stage of labour and a mean 23% reduction in 2nd stage as compared to Placebo group respectively. Blood loss >500ml was observed in 2% patients. Otherwise there were no adverse effects on mother or foetus. Phloroglucinol shortens the duration of labour, is non toxic to both mother and fetus and does not cause primary post partum haemorrhage

Epinefrina y analgesia epidural en el trabajo de parto inicial / Epinephrine and epidural analgesia in labor and initial labor

En la anestesia epidural caminando, el prolongado inicio de acción de la analgesia es uno sus principales problemas. Los objetivos de este trabajo son comparar la lactancia y duración análgesica de dos dosis de epinefrina (E) asociada a bajas dosis de bupivacaína (B) y sufentanil (S) en la analgesia del trabajo de parto (TP) inicial. Material y Método: Se estudiaron 60 pacientes con embarazo de término ASAI_II en TP inicial y con dilatación cervical menos o igual 4 cm. Grupo EO (Control) (N=20): B 10 mg + S 20 ug en solución fisiológica (SF) hasta completar 20 ml. Grupo E10 (n=20): B 10 mg + S 20 ug +E 10 ug en SF hasta 20 ml. Grupo E20 (n=20); B 10 mg + S 20 ug + E 20 ug en SF hasta 20 ml, epidural. Se midió latencia, duración, calidad analgésica, capacidad para deambular y efectos colaterales. Resultados: Sin diferencia demográficas. La lactancia se redujo significativamente entre los grupos al adicionar E en forma dosis dependiente. La duración fue mayor al adicionar epinefrina. No hubo bloqueo motor y todas caminaron. Hubo 20 por ciento de mareo en los grupos con E y ninguno en el control (p<0.05). El descenso de la PA fue igual y menor a un 15 por ciento entre los grupos. No hubo diferencias en incidencia de prurito, nauseas o vómitos

Experiencia en un hospital de Chiloé con el uso de prostaglandina E1 sintética en la inducción del trabajo de parto en embarazos de término / Experience at a hospital in Chiloé with the prostaglandine E1 use in the labor induction in term pregnancies

Trabajo descriptivo de una serie prospectiva en la inducción de trabajo de parto, utilizando un análogo sintético de prostaglandina E1 de formulación oral y administrándolo por vía vaginal, usado en pacientes hospitalizadas como ambulatorias. Se realiza inducción a 95 embarazadas de término con buena proporción céfalo pélvica e índice de Bishop menor de 6. El 65,3 por ciento de las pacientes eran portadoras de patología de alto riesgo obstétrico perinatal. Se logra inicio de dinámica uterina con resultado de parto en el 92,6 por ciento de los casos estudiados, de los cuales en un 84,1 por ciento fue parto vaginal espontáneo, en 12,5 por ciento, cesárea y un 3 por ciento, forceps. Se presentó sufrimiento fetal agudo en un 4,5 por ciento de los casos. La duración del trabajo de parto fue menor de 13 hr en el 82 por ciento de las pacientes. No hubo asfixia neonatal en el estudio. Se postula que este método es útil y seguro para la inducción de trabajo de parto, pero mayores y randomizados estudios son necesarios para comprobar su valor comparativo con otros métodos y diferentes dosificaciones

Evaluation of PGE2 gel for cervical ripening and induction of labour.

In a prospective study a single dose PGE2 gel 0.5 mg was given in 97 Low Bishop Score subjects, 12 hrs prior to indicated oxytocin or PGE2 tab induction for cervical ripening. Analysis of 97 subjects shows that it is very highly effective. 56 primi and 21 multi delivered spontaneously with gel administration only while 4 primi and 2 multi delivered vaginally following oxytocin and 3 more cases delivered vaginally following PGE2 tab administration and fewer caesarian section (11) were performed. The endo cervical administration of PGE2 was well tolerated and systemic PGE2 effects were minimal.