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Audrey Abella, 27 Mar 2020
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Propranolol does not shorten duration of labour induction in nulliparous women

Elaine Soliven
24 Feb 2020

Administering intravenous propranolol hydrochloride does not reduce the duration of labour induction for nulliparous women who undergo vaginal delivery, according to a study presented at SMFM 2020.

“Propranolol hydrochloride is a beta-adrenergic antagonist that has known activity in myometrium and small studies [have] suggested decreased duration of induced labour [with propranolol]. Our objective was to determine if the addition of propranolol to nulliparous induction of labour would decrease time to vaginal delivery,” said the researchers.

The trial enrolled 240 nulliparous women with a singleton nonanomalous gestation who underwent induction of labour between December 2017 and December 2018 at Mount Sinai Medical Centre in New York, US. Participants were randomly assigned to receive either 2 mg of intravenous propranolol (n=121) or saline placebo (n=119) 30 minutes after the start of labour induction. The primary endpoint of the study was the time from induction of labour to vaginal delivery. [SMFM 2020, abstract 30]

Among all the participants, 64.2 percent of the women had vaginal delivery.

The time from the start of induction of labour to vaginal delivery was comparable between women who received propranolol vs those receiving placebo (13.8 vs 14.3 hours; p=0.58).

Women on propranolol had a significantly lower rate of composite maternal morbidity (28.9 percent vs 41.2 percent; p=0.047; RR, 0.70, 95 percent confidence interval [CI], 0.49–1.00), post-partum haemorrhage (12.4 percent vs 21.8 percent; p=0.05), and transfusion (0.0 percent vs 4.2 percent; p=0.03) than those on placebo.

Data were analysed as intention to treat with a p-value of ≤0.05 considered significant,” the researchers said.

Women who received propranolol showed no difference to the placebo group with regard to the rate of Caesarean section (38 percent vs 33.6 percent; p=0.48) and the time to active labour (11.0 vs 11.2 hours; p=0.77) or time to full dilation (12.4 vs 12.8 hours; p=0.60).

Neonatal outcomes or composite morbidity were also comparable between the propranolol and the placebo treatment groups (RR, 0.74, 95 percent CI, 0.44–1.22).

“[In conclusion,] the addition of a one-time dose of propranolol to nulliparous induction of labour does not decrease [the] time to delivery or the rate of Caesarean section,” said the researchers, who highlighted that ”propranolol significantly reduces composite maternal morbidity without adverse neonatal effects.”

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Most Read Articles
Pearl Toh, 27 Mar 2020
Every-two-month injections of the long-acting cabotegravir + rilpivirine were noninferior to once-monthly injections for virologic suppression at 48 weeks in people living with HIV*, according to the ATLAS-2M** study presented at CROI 2020 — thus providing a potential option with more convenient dosing.
Stephen Padilla, 31 Mar 2020
Treatment with hydroxychloroquine appears to significantly reduce viral load in patients with the novel coronavirus disease (COVID-19), with its beneficial effects reinforced by adding azithromycin, results of a recent study have shown.
Elvira Manzano, 22 Nov 2017
A blood pressure (BP) reading of 130/80 mm Hg or higher is the ‘new high’ in the latest AHA/ACC* hypertension guidelines, a threshold that is tighter than the JNC 7** cutpoint of 140/90 mm Hg for stage 1 hypertension in the general population. The change will mean more patients being labelled with hypertension.
Audrey Abella, 27 Mar 2020
The angiotensin receptor blocker (ARB) losartan did not improve inflammation, T-cell immune recovery, or fibrotic activity among older persons living with HIV (PLHIV) and viral suppression, according to data presented at CROI 2020.