Propranolol and oxytocin versus oxytocin alone for induction and augmentation of labor: a meta-analysis of randomized trials.

Abstract

We sought to study the effect of propranolol co-administration with oxytocin during the latent and active phases of labor on labor outcomes. We searched Medline, Scopus, ClinicalTrials.gov and Cochrane Central Register databases. The meta-analysis was performed with the RevMan 5.1 software. Six studies were included in the present meta-analysis which enrolled 609 parturient. According to the findings of our study, propranolol administration during the latent phase effectively reduces the cesarean section rates (OR 0.49, 95 % CI 0.27, 0.89). However, this beneficial effect is not observed during the active phase of labor. The 5 min neonatal Apgar scores are not influenced by its administration (MD -0.07, 95 % CI -0.017, 0.02). Respectively, the neonatal admissions to a NICU are similar to those of neonates exposed only to oxytocin (OR 0.96, 95 % CI 0.36, 2.53). Propranolol's effect on the duration of the various stages of labor was underreported, however, evidence seem to support that it shortens the latent phase and possibly the total duration of labor. Firm results are, however, precluded due to the low number enrolled parturient and due to the significant methodological heterogeneity of included studies.