Meperidine for uterine dystocia and its effect on duration of labor and neonatal acid-base status: a randomized clinical trial.
OBJECTIVE
The aim of this study was to evaluate the effectiveness of meperidine, administered during the first stage of labor in patients with uterine dystocia, on the duration of labor and neonatal acid-base status at birth.


METHODS
We randomly assigned 240 nulliparous women with a singleton pregnancy at term who were diagnosed with uterine dystocia in labor at 4-6-cm cervical dilatation to receive either a single dose of 50 mg meperidine in 10 mL of saline (slow intravenous injection over 2 min) or 10 mL of isotonic saline (control group). The primary outcome measures were duration of labor (from the time of beginning of the intervention to the time of the expulsion of the fetal head) and umbilical cord arterial acid-base status.


RESULTS
The evidence revealed no statistically significant difference between the two groups in length of labor (188.2 ± 92.3 min in the meperidine group compared to 205.4 ± 96.1 min in the placebo group, P = 0.159). The pH of the umbilical cord arterial samples was lower in the meperidine group than in the control group, although the difference was not statistically significant (P = 0.089).


CONCLUSIONS
Because of the absence of any beneficial effect of meperidine on uterine dystocia, its use in labor should be limited to pain relief in the absence of epidural analgesia.
Departments of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt. tamer191074@gmail.com
Tamer A
TA
El-Refaie
Mourad M
MM
El-Said
Aktham A
AA
Shoukry
Soha M
SM
Khafagy
Adel S
AS
El-Din
Montaha M
MM
Badawy
D000136:Acid-Base Equilibrium / Q000187:drug effects*; D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004311:Double-Blind Method; D004420:Dystocia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000187:drug effects*; D008614:Meperidine / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
D000701:Analgesics, Opioid; D008614:Meperidine