Effect of Hyoscine Butyl Bromide on the Duration of Active Phase of Labour in Ekiti State, Nigeria: A Randomized Controlled Trial

Abstract

Background: Active management of labour is aimed at reducing the duration of labour without adverse effects on the mother and the foetus. The cervix consists majorly of fibrous tissues and smooth muscles with a rich supply of autonomic nerves which may play a role in cervical dilatation. Therefore, efforts are ongoing to explore the possible effect of smooth muscle relaxation property of hyoscine butyl bromide in facilitating cervical dilatation and shortening the active phase of labour. Objectives: To determine the effect of hyoscine butyl bromide on the duration of active phase of labour in Ekiti State, Nigeria. Study Design: A randomized, double-blind controlled trial comparing the effect of intravenous hyoscine butyl bromide to placebo on the duration of active phase of labour and it involved two groups namely; parturient who received 20mg intravenous hyoscine butyl bromide and parturient who received 5mls of intravenous normal saline as placebo. Methodology: A total of 272 parturient who satisfied the inclusion criteria were recruited for the study by systematic sampling. These were equal number of 136 participants each who received 20mg intravenous hyoscine butyl bromide and who received 5mls of intravenous normal saline as placebo. They were matched for gestational age and social status. The results were analysed using SPSS version 24 with appropriate tables and figures generated. Results: The mean duration of active phase of labour in hyosine butyl bromide group was 270.2±90.6 minutes compared to 303.6±94.5 minutes in placebo group (p value = 0.005). The estimated blood loss between the study and placebo groups who had vaginal delivery were (216.8±92.0 ml versus 210.0±66.4 ml; p value = 0.513) while that of those who had caesarean section were (454.2±109.7 ml versus 523.5±183.8 ml; p value = 0.254). The neonatal outcomes among study and placebo groups relative to 1 minute were (p value = 0.280) and 5 minute (p value = 0.238) APGAR scores. The neonatal admission into intensive care unit for hyosine butyl bromide group babies was 13.2% while that of placebo group babies was 14.7%; p value = 0.726. Conclusion: Intrapartum administration of intravenous hyoscine butyl bromide to parturient shortens the duration of active phase of labour.