Evidence map›Paper›PMID 41911945›Full record

ArticleObstetrics & gynecology science2026

Intravaginal magnesium sulfate as an alternative to intravenous dexamethasone for labor acceleration: first direct comparison in a bayesian adaptive trial.

Kobra Hosseini, Mahin Seifi Alan, Leila Asadpoor Asl, Niloofar Seighali, Haniyeh Rashidi, Bita Badehnosh, Hadith Rastad

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Article in Obstetrics & gynecology science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Kobra Hosseini *Clinical Research and Development Center of the Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Mahin Seifi Alan *Clinical Research and Development Center of the Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Leila Asadpoor AslClinical Research and Development Center of the Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Niloofar SeighaliCardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Haniyeh RashidiClinical Research and Development Center of the Kamali Hospital, Alborz University of Medical Sciences, Karaj, Iran.
Bita BadehnoshDepartment of Gynecology and Obstetrics, Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Hadith RastadImperial Clinical Trials Unit, Imperial College London, London, UK. h.rastad@imperial.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveLabor acceleration remains a major challenge in obstetric care. Although intravenous (IV) dexamethasone has been shown to be effective for labor acceleration, its systemic adverse effects limit its use. Intravaginal magnesium sulfate (MgSO4) may offer a potential alternative; however, comparative studies are needed. This study compared the safety and efficacy of these interventions for labor acceleration.

methodsThis Bayesian adaptive, three-arm randomized controlled trial enrolled 150 women in latent labor and assigned them to receive intravaginal MgSO4 (50%; 10 mL), IV dexamethasone (8 mg), or usual care. The primary outcomes were labor duration and change in Bishop score; secondary outcomes included Apgar scores.

resultsBoth active treatments significantly improved Bishop scores compared with control at 6 hours (3.06 vs. 3.05 points; P<0.001), with no significant difference between them. However, intravaginal MgSO4 reduced labor duration more effectively. It shortened the latent phase by 3.0 hours (95% credible intervals [CrI], 2.2 to 3.9) compared with dexamethasone (1.8 hours; 95% CrI, 1.2 to 2.4) and the active phase by 1.99 hours (95% CrI, 1.03 to 2.99) compared with 1.09 hours (95% CrI, 0.54 to 1.71), with a posterior probability of superiority exceeding 99.9%. All neonates had Apgar scores ≥8.

conclusionIntravaginal MgSO4 produced cervical effacement and dilation comparable to IV dexamethasone but achieved a significantly greater reduction in labor duration. Given similar neonatal safety outcomes, these findings suggest that intravaginal MgSO4 may be a preferable first-line agent for labor acceleration.

Indexed as

Adaptive clinical trialDexamethasoneLabor augmentationMagnesium sulfateObstetrics

Identifiers

PMID41911945
PMCPMC13216657

What Socratic holds

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.