Effectiveness and Safety of Camylofin in Augmentation of Labor: A Systematic Review and Meta-Analysis.

Abstract

This systematic review and meta-analysis assessed the effectiveness and safety of camylofin compared with other antispasmodics (drotaverine, hyoscine, valethamate, phloroglucinol, and meperidine) in labor augmentation. A systematic literature search until March 27, 2018, was performed, and data on the cervical dilatation rate (CDR) and duration of stages of labor reported in 39 eligible articles were analyzed using a random-effects model. CDR was significantly higher (0.38cm/h, 95% confidence interval (CI) 0.10 to 0.67, p = 0.007), and the duration of the first stage of labor was significantly shorter (-41.21 minutes, 95% CI, -77.19 to -5.22, p=0.02) in women receiving camylofin than those receiving other antispasmodics for labor augmentation. CDR was significantly higher with camylofin compared with valethamate (0.6cm/h, 95% CI 0.4 to 0.9, p < 0.0001) and hyoscine (20mg) (0.5cm/h, 95% CI 0.1 to 0.8, p = 0.02). The duration of the first stage of labor was significantly shorter with camylofin compared with hyoscine (20mg) (-59.9 min, 95% CI, -117.9 to -1.8, p = 0.04). However, CDR and the duration of first stage of labor were not statistically different between camylofin and drotaverine groups. The percentage of women having nausea and vomiting, cervical/vaginal tear, and postpartum hemorrhage were comparable with all antispasmodics, whereas tachycardia was least reported in women receiving camylofin (3, 2.07%) than those receiving other antispasmodics. This meta-analysis demonstrated the benefit of camylofin in labor augmentation with a faster CDR and reduction in the active first stage of labor in Indian women.