Comparing the Effects of Misoprostol and Propranolol with Misoprostol Alone for Induction of Labor in Mothers Referred to Kausar Qazvin Hospital: A Randomized Clinical Trial

Document Type : Original Article

Authors

1 Obstetrician and Gynecologist, Kowsar Educational and Medical Center, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

4 Medical Student, Faculty of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran.

5 Associate Professor, Department of Epidemiology, Non-communicable Diseases Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.

10.22038/ijogi.2026.27613

Abstract

Introduction: Childbirth is a physiological phenomenon that usually begins naturally with the spontaneous onset of pain in the 38-42 weeks of pregnancy and ends with the exit of pregnancy products. Spontaneous onset of labor and delivery is influenced by various factors such as changes in the level of estrogen, progesterone and prostaglandin hormones, changes in myometrial sensitivity to oxytocin and prostaglandins and the mutual effects of these factors. This study was conducted with aim to compare the effect of misoprostol and propranolol with misoprostol alone in induction of labor in mothers.
Methods: This double-blind randomized clinical trial was conducted on 240 pregnant women referred to Kowsar Hospital during 2024. The data collection tool was a checklist including the patient's personal characteristics and clinical data. The control group was given 50 micrograms of sublingual misoprostol up two doses along with placebo, and the intervention group was given 50 micrograms sublingual misoprostol up to two doses and 20 mg propranolol tablets every 6 hours up to two doses. Induction with oxytocin was continued with the onset of uterine contractions. Data analysis was performed with SPSS (version 25) and Chi-square test and independent t-test. P<0.05 was considered statistically significant.
Results: According to the results, there was no statistically significant difference between the two groups in terms of the number of pregnancies (p=0.676) and the Apgar score of the newborns (p=1.000). Moreover, the variables of hemoglobin before (p=0.959) and after (p=0.852) and its changes (p=0.842), systolic blood pressure (p=0.334) and diastolic blood pressure (p=0.484) did not have a statistically significant difference between the two groups. However, the mean of heart rate of the intervention group (85.18 ± 3.76) was significantly lower than that of the control group (86.22 ± 3.99) (P=0.040). In comparing the duration of labor phases, there was no statistically significant difference between the two groups in terms of latent phase (p=0.570), phase 1 (p=0.660), and phase 2 (p=0.704).
Conclusion: Adding oral propranolol to misoprostol did not accelerate the duration of labor phases. Among the clinical variables, only the mean heart rate of the intervention group (85.18) was lower than that of the control group (86.22).

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References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 12
February 2026
Pages 1-16

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