الفهرس 
Introduction & Aim of the work
Aim of the workOnly 14 pages are availabe for public view
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Abstract
The management of normal labor is both an art and a science. For decades, health providers have worked to manage labor actively and safely, with the goal of shortening the duration of painful labor. Reduction of Cesarean sections and other fetal and maternal complications is also an important aspect of labor management.
The use of pharmacological agents as oxytocin and prostaglandins in shortening labor by enhancing cervical dilation and effacement has been established.
Spasmolytic drugs are frequently employed to overcome cervical spasm and thus reduce the duration of labor. One of these spasmolytic is hyoscinebutylbromide which has been used to shorten the duration of labor.
Hyoscinebutylbromide acts in the context of labor has not yet been elucidated, and the evidence for its efficacy was previously largely anecdotal. Major studies have been carried out to evaluate the effects of the injectable or suppository form of HBB on cervical dilatation; a majority of these studies demonstrated the efficacy of HBB in augmenting labor.However, a few studies showed no effect of HBB on accelerating labor. In addition, some studies also used oxytocin in active management of labor, which would certainly affect the duration of labor and increase bias in the results. Including both primiparous and multiparous patients can also affect the results, because the duration of labor is shorter in multiparous women, even without any method of augmentation.
So, the current study conducted to study the efficacy of HBB in shortening the first stage of labor, to determine side effects of HBB and to determine the effect of HBB on cesarean section rate, maternal complication and fetal Apgar score.
We conducted a randomized controlled trial study in Obstetrics and Gynecology Department, Women Health Hospital, Faculty of Medicine, Assiut University comparing the effect of HBB and Placebo (saline) on shortening of the first and second stage of labor in both primigravida and multigravida.All eligible participants were randomly allocated to one of two groups:
group I: given solution A (BusCopan, HyoscineButylbromide ).
group II: given solution, 2 ml saline with 200 patients in each groups.
Exclusion criteria included; Previous uterine scarring,cephalopelvic disproportion,malpresentation,ante partum hemorrhage, multiple pregnancies, induced delivery, any medical disease, prolonged premature rupture of the membrane (more than 12 hours), epidural analgesia or receive any analgesic like pethidine, previous amputation of cervix or fothergill operation,pervious cervical cerclage.
We conclude that intravenously administered dose of 20mg HBB was effective in significantly decreasing the duration of the firstand second stages of labor inprimigravida and multigravida women, and not associated with any obvious adverse outcomes on mothers and neonates.