Effect of Intrapartum Hyoscine Butylbromide Administration on Duration of Labor and Mode of Delivery: A Systematic Review and Meta - Analysis

Background: Hyoscine Butylbromide (HBB) is a potent parasympatholytic drug with strong antispasmodic action contributing to cervical dilation during labor. Objective: We aimed to determine if hyoscine butylbromide (HBB) during labor is associated with shortened duration of labor. Search Strategy: We searched several electronic databases from inception to march 2019 using various search terms. Selection Criteria: Randomized controlled trials comparing HBB vs. placebo regarding labor duration. Data Collection and Analysis: After screening and data extraction, mean difference with 95% confidence interval (CI) for continuous data and odds ratio with 95% CI for categorical data were calculated. Main Results: Fourteen articles (2287 patients) were included. HBB shortens durations of first stage (MD = -60.86, 95% CI [-82.89 to -38.84]), second stage (MD = -3.18, 95% CI [-5.12 to -1.24]) and third stage of labor (MD = -0.84, 95% CI [-1.19 to -0.50]). Indeed, overall rate of cervical dilatation was greater in HBB group (MD= 0.65-minute, 95% CI, 0.51 to 0.80). However, HBB does not affect the rate of vaginal or cesarean deliveries. Conclusions: Hyoscine Butylbromide shortens the duration of all stages of labor and increases the rate of cervical dilatation. However, it does not affect the mode of delivery