The effect of oral propranolol plus oxytocin versus oxytocin only on the process and outcome of labor: A double-blind randomized trial

Abstract

ABSTRACT

Background: Prolonged labor can lead to maternal and neonatal complications. The purpose of this study was to investigate the effect of oral propranolol plus oxytocin versus oxytocin only on the process and outcome of labor.

Materials and Methods: In a randomized, double-blind, controlled trial performed in Ilam Mustafa hospital, a total of 146 nulliparous pregnant women at gestational age of 40-42 weeks were randomly allocated to receive 20 mg oral dose of propranolol or placebo plus oxytocin infusion (73 participants in each group). The outcome measures were the mean duration of labor stages, type of delivery, and neonatal outcome.

Results: The mean duration of active phase and the second stage of labor were significantly shorter in the propranolol group than in the placebo group on both the first and the second days of induction. The mean duration of third stage of labor was shorter in the propranolol group than in the placebo group, but the difference was not significant statistically on the first (P = 0.159) and second (P = 0.065) days. Frequency of cesarean section deliveries significantly decreased in the propranolol plus oxytocin group

compared to the placebo plus oxytocin group (P = 0.005, P = 0.015) on the first and the second days, respectively. No significant difference in the neonatal outcome measures, such as Apgar scores at 1 and 5 min and the need for neonatal intensive care unit (NICU) admission, was found between the groups.

Conclusions: This study showed that oral propranolol is an effective agent in both shortening the labor duration and reducing the frequency of cesarean section.

Key words: Cesarean section, Iran, labor, oxytocin, prolonged pregnancy, propranolol