Abstract
Objective: To analyze maternal and fetal perinatal outcomes on intervention of acetaminophen in labor.
Methodology: This double-blinded randomized controlled trial, (IRCT20220308054220N1) was conducted from May-October 2022 at Pharmacology department of public sector medical college, affiliated with National University of Medical Sciences in collaboration with gynaecology department of affiliated tertiary care hospital. It included primigravida’s in their first stage of labor. They were divided into 2 groups; placebo received 2 doses of I/V 100 ml normal saline whereas, paracetamol group received I/V 2 doses of 1000 mg paracetamol in 100 ml normal saline. Study inferences included duration of labor, neonatal and maternal outcomes.
Results: There were 154 primigravida’s in the study. In maternal outcomes, drug related side effects i.e. sedation (13vs.9, p=1), nausea (20vs. 3, p=0.693), vomiting (31vs.17, p=0.224) and dizziness (4vs.14, p=0.07) were similar between groups. Complications during delivery, perineal tears, laceration and, episiotomy did not significantly differ with paracetamol intervention. Duration of first (p=0.526) and second (p=0.362) stages, as well as total duration of labor (p=0.676) were comparable between groups. Analysing neonatal adverse effects of paracetamol, shoulder dystocia, perinatal asphyxia were not observed among participants. Mean fetal heart rate (p=0.10) was seen to be analogous between both groups. Apgar score at 1 minute was 6-8 and at 5 minute was 8-10.
Conclusion: Paracetamol is a safe medication with no significant neonatal and maternal side effects. It can be utilized to make labor less painful.

Key words: Acetaminophen, obstetric pain, labor complications.