The effect of hyoscine butylbromide on the first stage of labour in term pregnancies

Objective To determine whether hyoscine butylbromide shortens the first stage of labour, without an increase in maternal or neonatal complications. Design Randomised, double-blinded, controlled trial. Setting The Antenatal clinics and Labour and Delivery ward of the University Hospital of the West Indies, Kingston, Jamaica. Population Women in spontaneous labour at term. Methods Either drug or placebo was given intravenously once the women entered active labour. Main outcome measures The duration of the first stage of labour. Secondary outcomes included comparisons of the duration of the second and third stages of labour, blood loss at delivery, rate of caesarean section, and APGAR scores in the neonates between the two groups. Results A total of 129 women yielded data for analysis. Of these, 69 women received the placebo and 60 received hyoscine butylbromide. The mean time for the first stage in the control group was 228 minutes, compared with 156 minutes in the drug group, representing a decrease of 31.7% (P = 0.001). There was no significant change in the duration of the second and third stages of labour, and no difference in blood loss or in APGAR scores. There was a slight (but statistically insignificant) increase in the caesarean section rate. Conclusion Hyoscine butylbromide is effective in significantly reducing the duration of the first stage of labour, and it is not associated with any obvious adverse outcomes in mother or neonate.