Effectiveness and safety of drotaverine hydrochloride on first stage of cervical dilatation and in labor pain management A Meta-analysis
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 12
Abstract
Labor is a complex process that involves many factors such as myometrial contraction, cervical ripening, dilatation and the expulsion of the fetus and placenta. Prolonged labor increases the incidence of maternal distress, PPH, birth canal injury and puerperal sepsis. Fetus is also exposed to higher risk of infection, asphyxia, intracranial stress and increased incidence of operative delivery. Therefore, providing relief from labor pain and shortening duration of labor is a challenge for obstetricians. There are various agents now in use as smooth muscle relaxants which inhibit spasm that impairs cervical dilatation. They include hyoscine,valethamate bromide and drotaverine hydrochloride. The purpose of the meta-analysis was to assess efficacy, safety and potency of drotaverine hydrochloride in terms of duration of first stage of labor, incidence of cervical tears, maternal and fetal outcomes and cervical dilatation rate. Literature search was made using inclusion and exclusion criteria and comprehensive meta-analysis was carried out. All the studies carried out in comparing the efficacy of drotaverine and valethamate consistently showed that there is a significant decrease in first stage labor, pain duration and a significant increase in cervical dilatation rate with drotaverine as compared to valethamate. Drotaverine has definitely proven to be superior in shortening the duration of first stage of labor and significantly increases cervical dilatation rate as compared tovalethamate bromide thus providing a convenient, shorter, physiological and uncomplicated delivery without any adverse effects on maternal and neonatal outcome.
Authors and Affiliations
JB Sharma, P Vanamail
Keywords
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