Propranolol for Induction of Labor in Nulliparas trial a double-blind, randomized, placebo-controlled trial.

作者: Jessica R. Overbey , Joanne Stone , Stephanie Pan , Catherine A. Bigelow , Catherine A. Bigelow

DOI: 10.1016/J.AJOGMF.2020.100301

关键词:

摘要: Background Propranolol hydrochloride is a nonselective beta-adrenergic antagonist that has known activity in the myometrium. Small trials have shown propranolol decreases duration of induced labor, although those studies are limited by methodological variability. Objective Our objective was to determine whether addition single dose induce labor nulliparous women would decrease total time vaginal delivery. Study Design This study double-blind, randomized, placebo-controlled trial patients undergoing term induction with singleton, nonanomalous gestation. Subjects were randomized 2 mg intravenous or an identical-appearing saline placebo, administered 30 minutes after starting labor. Investigators, floor staff, and blinded drug allocation. The primary outcome Secondary outcomes included mode delivery, phases full dilation, composite maternal morbidity, neonatal morbidity. Data analyzed intention-to-treat analysis P value ≤.05 considered significant. Results In this study, 240 enrolled from December 2017 2018, 121 group 119 placebo group. groups had similar baseline characteristics. Of 154 (64.2%) delivered vaginally. There no significant difference start delivery (13.8±5.4 hours for vs 14.3±5.3 placebo; P=.58). also rate cesarean (38% 33.6%; P=.48), active (11.0±5.0 11.2±4.5 hours; P=.77), dilation (12.4±5.1 12.8±5.2 P=.60) receiving compared placebo. significantly lower morbidity (28.9% 41.2%; risk ratio, 0.70; 95% confidence interval, 0.49–1.00; P=.047). Rates postpartum hemorrhage (12.4% 21.8%; P=.05) transfusion (0% 4.2%; P=.03) treated (risk 0.74; 0.44–1.22). Conclusion there evidence 1-time However, reduced without adverse effects.

参考文章(25)
R N Kirkwood, P A Thacker, Effect of propranolol on the onset and duration of parturition in sows. Canadian Veterinary Journal-revue Veterinaire Canadienne. ,vol. 36, pp. 238- 239 ,(1995)
Yoshio Tanaka, Takahiro Horinouchi, Katsuo Koike, NEW INSIGHTS INTO β-ADRENOCEPTORS IN SMOOTH MUSCLE: DISTRIBUTION OF RECEPTOR SUBTYPES and MOLECULAR MECHANISMS TRIGGERING MUSCLE RELAXATION Clinical and Experimental Pharmacology and Physiology. ,vol. 32, pp. 503- 514 ,(2005) , 10.1111/J.1440-1681.2005.04222.X
K.-E. Andersson, L.Ph Bengtsson, I. Gustafson, I. Ingemarsson, The relaxing effect of terbutaline on the human uterus during term labor American Journal of Obstetrics and Gynecology. ,vol. 121, pp. 602- 609 ,(1975) , 10.1016/0002-9378(75)90459-7
Maryam Kashanian, Mohsen Fekrat, Zahra Zarrin, Narges S. Ansari, A comparison between the effect of oxytocin only and oxtocin plus propranolol on the labor (A double blind randomized trial) Journal of Obstetrics and Gynaecology Research. ,vol. 34, pp. 354- 358 ,(2008) , 10.1111/J.1447-0756.2008.00790.X
HATIM A. OMAR, LARRY A. RHODES, ROLANDO RAMIREZ, JELICA ARSICH, STANLEY EINZIG, Alteration of human placental vascular tone by antiarrhythmic medications in vitro. Journal of Cardiovascular Electrophysiology. ,vol. 7, pp. 1197- 1203 ,(1996) , 10.1111/J.1540-8167.1996.TB00498.X
Christian M. Pettker, Sean B. Pocock, Dorothy P. Smok, Shing M. Lee, Patricia C. Devine, Transcervical Foley catheter with and without oxytocin for cervical ripening: a randomized controlled trial. Obstetrics & Gynecology. ,vol. 111, pp. 1320- 1326 ,(2008) , 10.1097/AOG.0B013E31817615A0
C. Rouget, M. Bardou, M. Breuiller-Fouché, C. Loustalot, H. Qi, E. Naline, T. Croci, D. Cabrol, C. Advenier, M. J. Leroy, β3-Adrenoceptor Is the Predominant β-Adrenoceptor Subtype in Human Myometrium and Its Expression Is Up-Regulated in Pregnancy The Journal of Clinical Endocrinology and Metabolism. ,vol. 90, pp. 1644- 1650 ,(2005) , 10.1210/JC.2004-0233
Charla E. Simon, William A. Grobman, When has an induction failed Obstetrics & Gynecology. ,vol. 105, pp. 705- 709 ,(2005) , 10.1097/01.AOG.0000157437.10998.E7
M Bardou, C Loustalot, J Cortijo, B Simon, E Naline, M Dumas, S Esteve, T Croci, P Chalon, R Frydman, P Sagot, L Manara, E J Morcillo, C Advenier, Functional, biochemical and molecular biological evidence for a possible β3‐adrenoceptor in human near‐term myometrium British Journal of Pharmacology. ,vol. 130, pp. 1960- 1966 ,(2000) , 10.1038/SJ.BJP.0703491
Michael C Dennedy, Diarmaid D Houlihan, Helen McMillan, John J Morrison, None, β2- and β3-Adrenoreceptor agonists: Human myometrial selectivity and effects on umbilical artery tone American Journal of Obstetrics and Gynecology. ,vol. 187, pp. 641- 647 ,(2002) , 10.1067/MOB.2002.125277