Efficacy and safety of oral hyoscine used for outpatient cervical ripening among primiparous women with term pregnancy

Objective To assess the efficacy and safety of outpatient administration of oral hyoscine for cervical ripening. Methods In a randomized controlled trial at a university hospital in Tehran between September 2017 and December 2018, 100 primiparous women with singleton pregnancy at 38(0)-40(0)gestational weeks and Bishop score of 5 or less were randomized to either routine expectant management (control group) or 10 mg of oral hyoscine twice daily for 1 week, followed by once daily for 1 week (hyoscine group). Results Mean +/- SDBishop score in the hyoscine and control groups was, respectively, 1.19 +/- 1.38 and 1.08 +/- 1.70 at baseline, and 4.56 +/- 2.87 and 2.76 +/- 2.14 on admission for delivery (P=0.001). Duration of the first stage was 4.10 +/- 5.49 hours in the hyoscine and 5.29 +/- 6.48 hours in the control group (P=0.03). Duration of the second and third stages was, respectively, 0.52 +/- 0.53 and 0.14 +/- 0.25 hours in the hyoscine, and 0.59 +/- 1.08 and 0.12 +/- 0.15 hours in the control group. No adverse effects were reported. Conclusion Administration of oral hyoscine in an outpatient setting was found to ripen the cervix with no clinically significant adverse drug reaction. Iranian Registry of Clinical Trials (IRCT20180819040830N1)