Propranolol to decrease time to delivery: a meta-analysis of randomized controlled trials.
Objective: To assess the effect of propranolol on time to delivery among patients undergoing induction or augmentation of labor.
Methods: PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, and CINAHL (EBSCO) were searched from inception to December 2023. Methods: Randomized controlled trials (RCTs) that examined the impact of propranolol on time to delivery among patients undergoing induction or augmentation of labor were included. RCTs that included stillbirth before randomization, non-randomized trials, observational, cohort, case control, or studies in which the control group included an intervention other than standard care were excluded. Methods: Primary outcome was time to delivery after administration of propranolol among patients undergoing induction or augmentation of labor. The summary measures were reported as summary mean difference (MD) or relative risk with 95% of confidence interval (CI).
Results: Five RCTs including 660 patients were included in this meta-analysis. One study investigated the effect of propranolol compared to placebo among patients undergoing induction of labor (IOL) and did not demonstrate a significant decrease in time to delivery (828 minutes ± 324 vs 858 minutes ± 318, p=0.48). Four studies investigated the effect of propranolol among patients undergoing augmentation of labor and showed no significant decrease in time to delivery (MD, -2.98 minutes, 95% CI -21.6 to 15.6). Our pooled analysis demonstrated that the use of propranolol in IOL and augmentation was not associated with a decrease in time to delivery from administration of propranolol compared to placebo (mean difference, -4.33 minutes, 95% CI -22.48 to 13.83). The meta-analysis found no increased risk of PPH, blood transfusion, cesarean delivery rates, or NICU admission with the use of propranolol during labor.
Conclusions: The use of propranolol during induction and augmentation of labor did not significantly decrease time to delivery.