Yaneve N. Fonge MD , Helen B. Gomez Slagle MD , Richard J. Caplan PhD , Ellen L. Myers MD , Roxana Portillo , Anthony C. Sciscione DO
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引用次数: 0
Abstract
Background
Propranolol use has been proposed to shorten the length of labor following prolonged induction.
Objective
We sought to determine if administration of propranolol reduces the duration of labor among nulliparous individuals with prolonged latent labor following induction (IOL) at term.
Study Design
An open-label randomized clinical trial was conducted from July 2019 through June 2022 comparing 2mg of intravenous propranolol administration to usual care for prolonged latent labor. Nulliparous individuals undergoing IOL at ≥37 weeks with a singleton gestation and cervical dilation ≤2cm were included. Prolonged latent labor was defined as no cervical change ≥8 hours with ruptured membranes and receiving oxytocin. Labor management was standardized among participants. Our primary outcome was time to delivery.
Results
80 nulliparous participants (40 propranolol, 40 usual care) were randomized. Propranolol administration did not achieve a significantly faster median time to delivery compared to usual care, (propranolol: 27.7 hrs vs. usual care: 30.4 hrs, P<.52). Equal proportions of individuals delivered vaginally within 24hrs of randomization (propranolol: 27.5% vs. usual care: 27.5%, P<1.0). There was no difference in the cesarean delivery rate between the 2 groups (57.5% versus 55.0%, P=1.0) and no difference in time to active labor (propranolol: 19.5 hrs vs. usual care: 26.0 hrs, P<.22). There were no significant differences in maternal and neonatal outcomes.
Conclusion
Propranolol administration did not shorten the time to delivery or increase vaginal delivery in nulliparous individuals with a prolonged latent labor course. Our findings do not support the use of propranolol for prolonged latent labor in nulliparous patients undergoing IOL at term.
期刊介绍:
The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including:
Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women.
Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health.
Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child.
Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby.
Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.