Cervical dilatation rate following augmentation of dysfunctional labour with oxytocin alone versus oxytocin and drotaverine among term nulliparas in the Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Abstract

Background: Dysfunctional labour is the commonest abnormality of the first stage of labour. It complicates 50% of nulliparous deliveries and is associated with increased perinatal morbidity and mortality. Dysfunctional labour occurs when the progress in the active phase of labour is abnormally slow (<1 cm/hr). It is largely due to ineffective uterine contractions or slow cervical dilatation. Augmentation of labour with oxytocin is the standard management of dysfunctional labour as it enhances uterine contractions. In many cases, despite good uterine contractions slow progress persists due to cervical smooth muscle spasms. Drotaverine a smooth muscle relaxant can be used to relieve cervical smooth muscle spasms. Aim/objective: This study compared the cervical dilatation rate in term nulliparas following augmentation of dysfunctional labour with oxytocin versus oxytocin and drotaverine. Methods: The study was a single-blinded randomized clinical trial involving 156 term nulliparous women with dysfunctional labour, who were randomized into two groups. Each group had 78 participants and received either oxytocin with a placebo or oxytocin with drotaverine. They were monitored until delivery and the cervical dilatation rates in both groups were compared. Data obtained were analysed using SPSS version 23 software. The level of significance was set at 0.05. Results: The two groups were similar in their baseline characteristics, the mean pre-intervention cervical dilatation rate were also similar (0.53 cm/hr vs. 0.52 cm/hr, p = 0.85). Following augmentation, the cervical dilatation rate in the oxytocin-drotaverine group was significantly faster than in the oxytocin-placebo group (1.60 cm/hr vs. 1.20 cm/hr, p < 0.01). Conclusion: The use of drotaverine with oxytocin in managing dysfunctional labour in term nulliparous women leads to a faster cervical dilatation rate.