EFFECT OF RECTAL HYOSCINE BUTYL BROMIDE SUPPOSITORIES ON FIRST STAGE OF LABOR

Purpose: Prolong labour contributes to increased perinatal and maternal morbidity. Inhibitory impulses in the form of spasm often impair the dilatation of cervix and prolong the duration of labour. This study was undertaken to compare the effect of Hyoscine N Butylbromide [Buscopan] rectal suppository on duration of labour and rate of cervical dilatation. Method-400 patient were taken up for study. Of these 100 were primipara & multipara. In the multipara, only second para (OH=1001) were included to ensure comparability. 200 patients (100 primipara & 100 multipara), served as control. There were 59 patients in age group 15-20 yrs. and 114 patients in age group 21-25 yrs in study group. In the control group 52 patients were between 15-20 yrs of age and 117 patients between 21-25 years of age. Hyoscine butyl bromide suppositories were inserted per rectally (2 suppositories each containing 10 mg of drug) in study group. Mean duration of active phase of labor was taken from 3 cm dilatation to full dilatation of cervix. Results -In the study group mean duration of active phase was 3.43 his in primi and 1.79 hrs in multi. in the control group, mean duration of active phase was 4.5 hrs in primi and 3.42 his in multi respectively. Thus the active phase of labor was shortened by 1.07 hrs. in primi and 1.63 his in multi.The rate of cervical dilatation from 3 cm to full dilatation of cervix was calculated. The mean rate of cervical dilatation in the active phase of labor in primi study group was 2.04 cm/hr-, while in multi study group was 3.91 cm/hr. In the control group, mean rate of cervical dilatation for primi & multi were 1.5 cm/hr & 2.04 cm/hr respectively. In the study group 98% of patients delivered vaginally among primipara and 99% of multipara delivered vaginally. In the controls, 97% of primipara delivers vaginally & 99% of multipara had vaginal delivery. Only 1 baby had 5 min. Apgar score less than 7 in study group. Very few and minor side effects of hyoscine butyl bromide were noted Dryness of mouth was noted in 13% and maternal tachycardia in 3% of cases. Conclusion: Buscopan was effective in reducing the duration of active phase of labour and rate of cervical dilatation. Buscopan because of its convenience of administration (as rectal suppository) can be an alternative in rural setups where trained medical personnel may not be available most of the times.