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Abstract：
BACKGROUND: Prolonged labor increases the risk of maternal and fetal complications. The active management of labor has been proven effective in lowering neonatal and maternal morbidity by shortening the duration of labor. Several pharmaceutical and non-pharmaceutical approaches are currently being used in the active management of labor. Hyoscine Butyl-bromide (HBB) is an antispasmodic and anticholinergic drug that acts as a cervical spasmolytic agent. It has been widely used in everyday practice for shortening the active phase of labor. Nonetheless, only a few trials have been conducted on the topic.
OBJECTIVE: This review aimed to evaluate whether HBB is effective in decreasing the mean duration of the active phase of labor.
METHODS: An electronic search was conducted on Medline (through PubMed), Scopus, ClinicalTrials.gov, EMBASE, PROSPERO, and Cochrane Library from the beginning of all databases to December 2019. Results were limited to randomized trials. Restriction for English language was applied. Inclusion criteria were: randomized clinical trials regarding primiparae or multiparae women with a singleton vertex pregnancy at term who were randomized to HBB versus placebo or other drugs. Primary outcome evaluated was the mean reduction of the active phase of labor.
METHODS: Eight randomized clinical trials, including 1159 pregnant women, were analyzed. Significant heterogeneity (I2 = 99 %) between studies was noted for the primary outcome. The active phase of labor duration was significantly reduced in the treatment arm compared to controls [mean difference (MD) -83.93 min (95 % confidence interval (CI) -163.61, -4.25)]. Achieved reduction in primiparae women was -55.09 min [95 % CI -68.83, -41.35; I2 = 37 %].
CONCLUSIONS: HBB is an effective treatment to shorten the duration of the active phase of labor in primiparae and multiparae women.
OBJECTIVE: This review aimed to evaluate whether HBB is effective in decreasing the mean duration of the active phase of labor.
METHODS: An electronic search was conducted on Medline (through PubMed), Scopus, ClinicalTrials.gov, EMBASE, PROSPERO, and Cochrane Library from the beginning of all databases to December 2019. Results were limited to randomized trials. Restriction for English language was applied. Inclusion criteria were: randomized clinical trials regarding primiparae or multiparae women with a singleton vertex pregnancy at term who were randomized to HBB versus placebo or other drugs. Primary outcome evaluated was the mean reduction of the active phase of labor.
METHODS: Eight randomized clinical trials, including 1159 pregnant women, were analyzed. Significant heterogeneity (I2 = 99 %) between studies was noted for the primary outcome. The active phase of labor duration was significantly reduced in the treatment arm compared to controls [mean difference (MD) -83.93 min (95 % confidence interval (CI) -163.61, -4.25)]. Achieved reduction in primiparae women was -55.09 min [95 % CI -68.83, -41.35; I2 = 37 %].
CONCLUSIONS: HBB is an effective treatment to shorten the duration of the active phase of labor in primiparae and multiparae women.
摘要：
背景：延长产程会增加母婴并发症的风险。通过缩短分娩时间，积极管理分娩已被证明可有效降低新生儿和产妇的发病率。目前正在使用几种药物和非药物方法来积极管理劳动。Hyoscine丁基溴（HBB）是一种抗痉挛和抗胆碱能的药物，可作为宫颈痉挛剂。它已广泛用于日常实践中，以缩短劳动的活跃阶段。尽管如此，关于该主题仅进行了一些试验。
目的：本综述旨在评估HBB是否能有效减少产程活跃期的平均持续时间。
方法：在Medline（通过PubMed）上进行了电子搜索，Scopus,ClinicalTrials.gov,EMBASE,PROSPERO,和Cochrane图书馆从所有数据库的开始到2019年12月。结果仅限于随机试验。对英语语言的限制被应用。纳入标准是：关于初产妇或多胎妇女单胎顶点妊娠的随机临床试验，这些妇女被随机分配到HBB与安慰剂或其他药物。评估的主要结果是分娩活跃期的平均减少。
方法：8项随机临床试验，包括1159名孕妇,进行了分析。对于主要结局，研究之间存在显著的异质性（I2=99%）。与对照组相比，治疗组的活跃期时间显着减少[平均差异（MD）-83.93分钟（95％置信区间（CI）-163.61，-4.25）]。初产妇减少的成功率为-55.09min[95%CI-68.83,-41.35;I2=37%]。
结论：HBB是缩短初产妇和多产妇女活产期持续时间的有效治疗方法。
目的：本综述旨在评估HBB是否能有效减少产程活跃期的平均持续时间。
方法：在Medline（通过PubMed）上进行了电子搜索，Scopus,ClinicalTrials.gov,EMBASE,PROSPERO,和Cochrane图书馆从所有数据库的开始到2019年12月。结果仅限于随机试验。对英语语言的限制被应用。纳入标准是：关于初产妇或多胎妇女单胎顶点妊娠的随机临床试验，这些妇女被随机分配到HBB与安慰剂或其他药物。评估的主要结果是分娩活跃期的平均减少。
方法：8项随机临床试验，包括1159名孕妇,进行了分析。对于主要结局，研究之间存在显著的异质性（I2=99%）。与对照组相比，治疗组的活跃期时间显着减少[平均差异（MD）-83.93分钟（95％置信区间（CI）-163.61，-4.25）]。初产妇减少的成功率为-55.09min[95%CI-68.83,-41.35;I2=37%]。
结论：HBB是缩短初产妇和多产妇女活产期持续时间的有效治疗方法。
