Efficacy of phloroglucinol in shortening the first stage of labor: systematic review and meta-analysis of randomized controlled trials

J Matern Fetal Neonatal Med. 2022 Dec;35(25):7036-7042. doi: 10.1080/14767058.2021.1936488. Epub 2021 Jun 8.

Abstract

Background: Protracted labor is associated with an elevated risk of maternal and fetal complications. Results of randomized controlled trials on the efficacy in labor of phloroglucinol (PHL), a pure antispasmodic drug, are uncertain.

Objectives: To evaluate whether PHL is effective in shortening the first stage of labor.

Search strategy: MEDLINE, EMBASE, LILACS, Scopus, ClinicalTrials.gov, and the Cochrane Library were searched from inception to July 2020.

Selection criteria: Randomized controlled trials (RCTs) concerning women with a singleton vertex pregnancy at term who were treated with PHL.

Data collection and analysis: Relevant data were extracted and tabulated. Review Manager 5.3 was used for data analysis. Primary outcome evaluated was the mean reduction of the first stage of labor.

Main results: Five RCTs, including 487 pregnant women, were analyzed. The first stage of labor duration was significantly shorter in the treatment arm compared to the control group [MD-113.21 min (95% CI-119.63,-106.79)]. A significant shortening of the second stage was achieved in the PHL group [MD-11.12 min (95% CI-12.64,-9.75)] while no differences were reported for the third stage.

Conclusions: PHL might represent an effective treatment to shorten the duration of the first and second stage of labor.

Synopsis: A meta-analysis of 5 trials found that Phloroglucinol favorably impacts on the total duration of the labor in primiparae and multiparae women with a singleton pregnancy.

Keywords: Phloroglucinol; active management; active phase; duration; labor; shortening.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Female
  • Humans
  • Labor, Obstetric*
  • Parasympatholytics / therapeutic use
  • Phloroglucinol* / therapeutic use
  • Pregnancy
  • Randomized Controlled Trials as Topic

Substances

  • Phloroglucinol
  • Parasympatholytics