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Diazepam at the Active Phase of Labor

Phase 2
Conditions
Pain
Prolonged Labour
Interventions
Drug: normal saline/diazepam at the active phase of labor
Registration Number
NCT02232035
Lead Sponsor
Navy General Hospital, Beijing
Brief Summary

Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour are much greater in poor resource settings. Active management of labour versus physiological, expectant management, has shown to decrease the occurrence of prolonged labour. Administering sedatives during labour could also lead to faster and more effective dilatation of the cervix. Interventions to shorten labour, such as sedatives, can be used as a preventative or a treatment strategy in order to decrease the incidence of prolonged labour. As the evidence to support this is still largely anecdotal around the world. (Cochrane Database of Systematic Reviews 2013,CD009243.pub3.; Cochrane Database of Systematic Reviews 2012, CD009223.pub2.)

Hypothesis: Diazepam reduced the duration of labor and the severity of pain in labor.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
400
Inclusion Criteria
  • primigravida
  • at term
  • singleton pregnancy
  • cephalic presentation
  • spontaneous labour
  • intact membranes at the beginning of active phase
Exclusion Criteria
  • induced labour
  • spontaneous rupture of membranes at randomisation
  • obstetric complications, or medical complications
  • previous uterine scarring, or cervical surgery
  • cervical dilatation of more than 5 cm
  • other antispasmodics in the first stage
  • malpresentation, macrosomia, cephalopelvic disproportion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
normal saline, active phase of labornormal saline/diazepam at the active phase of laborA single dose intravenous injection of normal saline (2ml) at the beginning of active phase of labor in the group.
diazepam, active phase of labornormal saline/diazepam at the active phase of laborA single dose intravenous injection of diazepam (10mg, 2ml) at the beginning of active phase of labor in the group.
Primary Outcome Measures
NameTimeMethod
Duration of laborlabor

Duration of first stage of labor. Duration of second stage of labour. Duration of third stage of labor. Total duration of labor.

Secondary Outcome Measures
NameTimeMethod
Pain reliefevery 30 minutes during the 3-hour period after administration of the trial drug

Pain severity during the last contraction was assessed using a Visual Analogue Scale (VAS) (with anchor points of 0 = no pain at all and 10 = the most excruciating pain) every 30 minutes during the 3-hour period after administration of the trial drug. This information was used to derive measures of pain relief at each time-point using absolute change in pain intensity (on a 10-cm VAS) from pre-analgesia (baseline). In addition to analysing all the time-points together (as described in the section on statistical analysis), a specific analysis of pain relief at 60 minutes was conducted, because it was anticipated that the maximum analgesic effect would occur then. (Wee MYK, Tuckey JP, Thomas PW, Burnard S. A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: a two-centre randomised blinded controlled trial. BJOG 2014;121:447-456.)

Type of deliverypost partum, immediately
Rate of cervical dilatationat the active phase of labor

Trial Locations

Locations (1)

Navy General Hospital

🇨🇳

Beijing, Beijing, China

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