To compare the efficacy of drotaverine hydrochloride with hyoscine butylbroumide for increasing the rate of cervical dilatation

Uzma Kausar, Nikhat Siddiqui


Background: In order to accelerate the labour apart from early amniotomy and early administration of oxytocin, the use of antispasmodic agents like drotaverine and hyoscine butylbromide to hasten the first stage of labor is a common practice. Considering the promising results of hyoscine butylbromide, the present study was planned to to compare the efficacy of drotaverine hydrochloride with hyoscine butylbroumide for increasing the rate of cervical dilatation.

Methods: This prospective placebo-controlled crossover study was carried out at Department of Obstetrics and Gynaecology, Era’s Lucknow Medical College, Lucknow. The study was conducted on 60 women in labour who were randomly allocated to group I, group II and group III of 20 patients each.  In group I, no intervention was done and comprised the control group. The women in group II were injected intramuscularly one ampoule (20mg) of hyoscine butylbromide. The women in Group III were injected Inj. Drotavrine one ampoule (40mg) intramuscularly at 3 cm dilatation. The data collected was analysed using SPSS Version 15.0. Suitable statistical tests were applied.

Results: Majority of subjects were aged between 21-30 years, were multipara and had spontaneous labour. Mean duration of first stage of labour ranged from 3 hoour 34 minutes (drotaverine hydrochloride) to 5 hour 45 minutes (control group) showing a significant intergroup difference. Mean total duration of labour ranged from 4 hr 11 minutes (drotaverine hydrochloride and hyoscine butylbromide groups) to 6 hr 26 minutes (control group) showing a significant intergroup difference (p <0.001). Majority of deliveries were full term normal deliveries.

Conclusions: Both drotaverine hydrochloride and hyoscine butylbromide could effectively reduce first stage as well as total duration of labour. Further studies are recommended to establish the comparative efficacy in terms of a side effect profile and relatively efficacy in view of various clinico-demographic variables.


Drotaverine hydrochloride, Hyoscine butylbromide, Labour

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Boylan PC. Active management of labor: results in Dublin, Houston, London, New Brunswick, Singapore, and Valparaiso. Birth 1989;16:114-8.

O‘Driscoll K, Stronge JM, Minogye M. Active management of labor. J Obstet Gynaec. 1970;77(5):385-9.

Bohra U, Donnelly J, O'Connell M, Geary M, Mac Quillian K, Keane DP. Active mangement of labour revisited: the first primiparous labours in 2000. J Obstet Gynaecol. 2003;23:118-20.

Singh KC, Jain P, Goel N, Saxena A. Drotaverine hydrochloride for augmentation of labour. Int J Gynaecol Obstet. 2004;84:17-22.

Hudecek R, Nagy J, Unzeeitig V. The effect of spasmolytics on dilatation of the uterine cervix. Ceska Gynaekol 1997;62:11-14.

Ahmad S, Rauf B, Shafiq A. Use of Spasfan in labour. J Himont Med. 2002;1:14-8.

Tehalia MK, Sajjan GR, Korbu J, Venkatesh S, Biradar R. A comparative study of hyoscine butylbromide versus drotaverine hydrochloride in first stage of labor. J Obstet Gynecol India. 2008;58(3):230-4.

Sadler LC, Davison T, Mccwan LM. A randomized controlled trial and meta-analysis of active management of labour. BJOG. 2000;107:909-15.

Sharma JB, Pundir P, Kumar A, Murthy NS. Drotaverine hydrochloride vs. valethamate bromide in acceleration of labor. Int J Gynaecol Obstet. 2001;74(3):255-60.

Impey L, Boylan P. Active management of labour revisited. Br J Obstet Gynaecol. 1999;106:183-7.

Pates JA, Satin AJ. Active management of labor. Obstet Gynecol Clin N Am. 2005;32:221-30.

Ritchie JW, Boyle DD. The active management of labour. Br J Hosp Med. 1980;26(1):61-5.

O’Herlihy C. Active management: a continuing benefit in nulliparous labor. Birth. 1993;20:95-7.

O’Driscoll K, Foley M, Macdonald D. Active management of labor as an alternative to cesarean section for dystocia. Obstet Gynecol. 1984;63:485-90.

Effect of hyoscine-N-butylbromide on duration of labour in term pregnancies in North Okkalapa General Hospital. Dissertation for Master of Medical Sc. (Obs. Gyn.), University of Medicine, Yangon, Burma, 2010. Available at Accessed on 12 December 2016.

Sujatha V. Comparision of buscopan and epidosin on cervical dialatation in labour. Global J Med Res. 2010;10(2):18-21.

Ajmera SK, Shah PK, Shinde GA. Comparative Study of drotaverine v/s valethamate in cervical phase of labour. Bombay Hospital Journal. 2006;48(2):305-9.

Barachio HM, Kamath J, Kunkalekar K, Jacob C. Hyoscine N-butyl bromide in acceleration of labour. J Obstet Gynaecol Ind. 1984;34(3):510-3.

Davinder K, Ravinder K. Comparison of drotaverine and episodin in first stage of labour. J Obstet Gynaecol Ind. 2003;53(4):449-52.

Gupta B, Nellor V, Mittal S. Drotaverine hydrochloride versus hyoscine-N-butylbromide in augmentation of labor. Int J Gyn Obs. 2008;100(3):244-7.

Chan DPC. The use of buscopan during the first stage of labour. The Bulletin of the Hong Kong Chinese Medical Association. 1963;15:69-71.

Sirohiwal D, Dahiya K, De M. Efficacy of hyoscine-N-butyl bromide (Buscopan) suppositories as a cervical spasmolytic agent in labour. Aust NZJ Obstet Gynaecol. 2005;45(2):128-9.

Samuels LA, Christie L, Roberts GB, Fletcher H, Frederick J. The effect of hyoscine butylbromide on the first stage of labour in term pregnancies. BJOG. 2007;114(12):1542-6.

Raghavan R. The effect of hyoscine butyl bromide on the first stage of labour in term pregnancies. BJOG. 2008;115(8):1064.

Khosla AH, Bala I, Dahiya K, Sangwan K. Comparative study of the efficacy of valethamate bromide with drotaverine in normal labour. J Obst Gynaecol India. 2003;53(6):568-70.

Singh KC, Jain P, Goel N, Saxena A. Drotaverine hydrochloride for augmentation of labor. Int J Gynaecol Obstet. 2004; 84(1): 17-22.

Roy A, Patra KK, Mukhopadhyay S, Guha S. Study of drotaverine on first stage of labour and pregnancy outcome. J Indian Med Assoc. 2007;105(8):450-2.

Thapa M, Saha R, Pradhan A, Shrestha S. Effectiveness of drotaverine hydrochloride in progression of labour. NJ Obstet Gynaecol. 2007;2(2):9-11.

Madhu C, Mahavarkar S, Bhave S. A randomised controlled study comparing drotaverine hydrochloride and valethamate bromide in the augmentation of labour. Arch Gyn Obs. 2010;282(1):11-5.