Propranolol and Misoprostol versus Misoprostol Alone for Induction of Labour in Primigravidas

Abstract

Background Induction of labor is indicated when risks to maternal or fetal health out weight benefits of continuing the pregnancy. One of the most common reasons for labor induction is postterm pregnancy (ie,> 41 weeks of gestation). Objectives The aim of the study is to compare propranolol and misoprostol versus misoprostol alone for induction of labour in primigravidas. Patients and Methods This study included one hundred and twenty eight pregnant fullterm primigravida women, they were divided randomly into two equal groups. In both group, every patient received 25 microgram of misoprostol vaginally under aseptic prequations then every 6 hours with maximum 4 doses until efficient uterine contractions is reached three or more in 10 minutes each lasting for 45 seconds for induction of labor. Then after 30 minutes patients in group A received oral propranolol 20 mg and patients in group B received oral placebo in the form of sugary tablets, then womens monitored for fetal and maternal wellbeing and progress of labor. Results In this study, all the parturients were primigravid, it was highly considered to recruit parturient of almost similar conditions. The mean age of women included in the study was (23.3+/4.1) and the mean gestational age of the parturient was range (38 – 42) weeks. The mean pre induction Bishop score was range (2-6), we select only women with Bishop score of 6 or less considering the fact that the main goal for using medication for induction of labor was the reppening of an unfaverable cervix. There was no statistical difference between both groups as regards initial basic characteristics. There was no statically significant difference between propranolol and placebo research group regarding birth weight, apgar score at 1 and 5 minutes and NICU administration and patients satisfaction. Conclusion From the previous results regarding the propranolol effectiveness and safety, it dose not seem to negatively influence the fetus as apgar score at 1 and 5 minutes and the need for NICU admission were not influenced by its administration. And on the other hand, propranolol was significant in reduction the time latent phase and therefore the total duration of labor. Taking in mind this significant results it seems that propranolol might become a useful obestetrical tool for induction of labor in the future.