Propranolol Rescue of Prolonged Labor (PROPEL): A Randomized, Double-blind, Placebo-controlled Multicenter Investigation of Propranolol's Effect on Cesarean Delivery Rate Among Women With Prolonged Labor
Propranolol Rescue of Prolonged Labor (PROPEL): A Randomized, Double-blind, Placebo-controlled Multicenter Investigation of Propranolol's Effect on Cesarean Delivery Rate Among Women With Prolonged Labor
A double-blind placebo controlled randomized trial comparing cesarean delivery rates in women given IV propranolol versus placebo for treatment of prolonged labor.
A double-blind placebo controlled randomized trial comparing cesarean delivery rates in 326 women given IV propranolol (2 mg with one possible repeat dose greater than 2 hours later) versus IV placebo for treatment of prolonged labor.
Inclusion Criteria:
English-speaking
>= 36 weeks gestation
Singleton pregnancy
Vertex presentation
No contraindication to a vaginal delivery
Meets at least one study criteria for prolonged labor:
Exclusion Criteria:
Severe preeclampsia: as patients will be receiving magnesium and possibly labetalol for hypertension control
Receiving other beta blocker
Maternal heart rate < 70 beats per minute, systolic blood pressure <90 mmHg, or diastolic blood pressure <50 mmHg on two sets of vital signs in the 1 hour prior to study drug administration: given that bradycardia and hypotension are possible side effects of propranolol
History of any form of asthma: as this is a contraindication to beta blocker use
Diabetes requiring insulin in labor: given the potential risk of neonatal hypoglycemia in the neonate
Any cardiac condition for which β blockade is contraindicated (cardiogenic shock, sinus bradycardia, and greater than first degree heart block)
Known hypersensitivity to propranolol
Intrauterine fetal demise since different labor protocols are used in these women
Major fetal congenital anomaly since rate of cesarean may be inherently different in these women, unrelated to labor