Reducing the length of labor is a highly desirable goal of intrapartum care, both from a
perspective of maternal and fetal well-being, and for the providers of the birth services.
Avoiding along, protracted labor entails shorter exposure to pain, anxiety and stress and
would thus translate into a major improvement in maternal satisfaction with the childbirth
experience.
Based on the premise that shortening the length of labor is beneficial, interventions aimed
at accelerating the progression of labor have been introduced routinely as part of standard
labor management and care throughout the 20th century. Certain labor accelerative procedures,
such as amniotomy, became common practice and have been put to the acid test of randomized
control trials to evaluate their efficacy. Use of anticholinergics/antispasmodics as a method
of augmenting labor was first described in 1937 by Hirsch, who reported a decrease in labor
length by two to four hours following Intrapartum administration of an atropine-like drug
(Syntropan®)mainly among older nulliparas.
Drotaverine, an isoquinolone derivative is a superior smooth muscle relaxant which acts
specifically on spastic sites and corrects the cAMP and calcium balance relieving smooth
muscle spasm.
This inhibitory action is detected only in lower uterine segment during labor since muscle
fibers in upper uterine segment are strongly affected by contractile effect of oxytocin. Use
of drotaverine during pregnancy is free of any teratogenic and embryotoxic effects.
The Research question is: Does the use of antispasmodic Drotaverine shorten the duration of
active first stage of labor in nulliparous women as compared to placebo?