The Effect of Hyoscine N-Butyl Bromide Rectal on the Duration of Labour and Rate of Cervical Dilatation: A Systematic Review and Meta-Analysis

Abstract

Objective: The current meta-analysis was designed to investigate the impact of Hyoscine N-butyl bromide (HBB) rectal on labour duration and the rate of cervical dilatation by consolidating the available data.

Methods: The search of Medline through the PubMed interface, Scopus, ScienceDirect, and the Cochrane Central Register of Controlled Trials (CENTRAL) was performed for original articles concerning the effects of HBB rectal on the duration of labour published prior to 26 June 2023. Search terms were based on Medical Subject Headings without time and language restrictions. They included: Hyoscine, Scopolamine, HBB, Buscopan, Buscolysin, Buscapine, rectal, suppository, childbirth, delivery, active phase, second stage, cervical dilatation, labour, labour, and duration of labour. The Comprehensive Meta-Analysis V3 software was used for all analyses.

Results: Five randomized control trials and 1 non-randomized study involving 1310 women were included in the systematic review. Two studies were excluded from the meta-analysis because of heterogeneous interventions and a lack of mean and SD results. The results determined that HBB rectal administration significantly decreased the duration of the active phase (pooled mean difference -193.893; 95% CI -229.173 to -158.613, P < 0.001; I² squares = 90.097%) and second stage of labour (pooled mean difference -2.911; 95% CI -5.486 to -0.336, P = 0.027; I² squares = 90.097%). Also, the cervical dilatation rate in the active phase of labour was 0.981 cm/h higher than in the control group (I² = 0.0%; P < 0.001).

Conclusion: This meta-analysis found that HBB rectal administration shortened the active labour phase and second stage and increased the rate of cervix dilatation; consequently, it can be used as a cost-effective intervention for low-risk pregnant women during labour. However, our findings also suggest that more robust clinical trials are required to generate evidence and confirm the use of HBB during labour for clinical practice guidelines.

Keywords: dilatation; gynaecology; labour stage; midwifery.