The effect of hyoscine butyl bromide on the active phase of labour among primiparous women delivered at the Jos University Teaching Hospital

Abstract

Background: Labour is a physiological process to expel products of conception to the external environment. More often than not, it results in the delivery of a healthy baby to a happy mother. However, it has also been associated with a significant number of adverse maternal and fetal outcomes. Over the years several steps and interventions have been taken to reduce these adverse outcomes. One of such intervention is the reduction of the duration of labour which has been found to improve neonatal outcomes. Hyoscine-Butyl Bromide has been shown to reduce the duration of labour, however, it is currently not recommended for labour intervention because no beneficial effects have been associated with its use yet and it remains an area prioritized for research.

Objective: To establish the effects of Hyoscine Butyl-bromide in the outcome of labour among primiparous women delivering at the Jos University Teaching Hospital (JUTH) and to contribute towards the management of these patients.

Design: This was a hospital-based double-blind placebo-controlled clinical trial

Methodology: In this study 120 women were recruited by convenience sampling and randomized into the 3 arms of the study. One arm received placebo, 2^nd arm received 20mg of Hyoscine-Butyl Bromide and the 3^rd arm received 40mg of Hyoscine-Butyl Bromide (HBB). Their labours were managed actively and outcomes were documented in a proforma. Statistical analysis was done using SPSS software version 20 and results calculated.

Results: Ninety-seven women had spontaneous vaginal delivery, 18 had Caesarean Sections and 5 had operative vaginal delivery. The mean duration of active phase of labour in the placebo arm was 325.84 minutes, it was 272.35 minutes in the 20mg HBB arm and 265.03 minutes in the 40mg HBB arm. This difference however was not shown to be statistically significant. There was no significant increase in adverse neonatal outcomes in any of the groups and there were no noted improved maternal or neonatal outcomes. Side effects were noted to be more in the 40mg HBB group.

Conclusion: There was an average of 53 minutes reduction in the duration of active phase of labour with the administration of 20mg of Hyoscine Buytl Bromide and a further average reduction of 7 minutes by an additional 20mg of Hyoscine Butyl Bromide.

There is not enough evidence from this study to recommend the use of hyoscine butyl bromide as an intervention in labour due to the absence of any beneficial effect and the presence of some unpleasant side effects.