Comparison Effect of Oral Propranolol and Oxytocin Versus Oxytocin Only on Induction of Labour in Nulliparous Women (A Double Blind Randomized Trial) Key words: Induction of labour, Propranolol, Caesarean delivery, Oxytocin

IntrOductIOn Induction of labour is defined as stimulation of uterine contractions before they occur spontaneously and its prevalence has increased in the United States from 9.5% of births in 1990 to 22.1% of births in 2004 [1]. Although induction of labour has recently been on the rise for purposes of convenience or to accommodate busy schedules, the main reasons include prolonged pregnancies and maternal and foetal indications [2]. Prolonged pregnancies can result in development of oligohydramnios, macrosomia, and intra–uterine foetal demise at a later gestational age [3]. Induction of labour is thought to be advantageous for the mother or baby [4]. Induction of labour is directly relevant to the health related Millennium Development Goals (MDGs) and it may also contribute to lowering of caesarean section rates [5]. Labour can be induced by mechanical and pharmacological methods such as use of prostaglandins [6] and Oxytocin [7]. Oxytocin can be used alone or in combination with other agents for labour induction. Propranolol is one of these agents which have been suggested for assisting labour induction [8]. In several studies, it was seen that Propranolol could induce contractions in the pregnant uterine musculature [9,10]. Propranolol, as a β-adrenergic receptor-blocking drug, can reversed the inhibitory effect of β-agonist isoproterenol on human uterine motility [11]. In a study, its intravenous use once or twice in a 2 mg dose was found to shorten the duration of labour induction, without any significant adverse effects on neonates A na es th es ia s ec tio n