Prophylaxis of the Occurrence of Hyperbilirubinemia in Relation to Maternal Oxytocin Infusion with Steroid Treatment

Abstract

This study was carried out to investigate the steroid prevention on the occurrence and the severity of red blood cell destruction by the effect of oxytocin usage for labor induction. Venous cord blood was collected from the pregnancies who had oxytocin-induced or augmented labors (20), oxytocin-infused deliveries with steroid use (20), deliveries without oxytocin use (20) and cesarean sections (20). Evaluation of the data showed significant increase in serum bilirubin level, serum lactic dehydrogenase activity, erythrocyte fragility and reticulocyte count (p < 0.0083), and a significant decrease in hemoglobulin concentration, packed red cell volume fraction (p < 0.01) in groups with labor induction or augmentation with oxytocin in comoparison to deliveries with oxytocin plus steroid use and the two other methods of delivery. Moreover, with regard to the above data, no significant difference was observed between the deliveries other than oxytocin-only use. Mean corpuscular volume in the oxytocin group was apparently (not significant) higher than the steroid group. The results of this study suggest that the use of 16 mg dexamethasone 21-phosphate at the beginning of the induction or augmentation of labor with oxytocin, followed by an additional 4-mg dose 4 h later intravenously, is advantageous for the prevention of erythrocyte destruction.

Can Anesthesiologic Strategies for Caesarean Section Influence Newborn Jaundice?

“…Many other factors, although not strictly connected to neonatal bilirubin metabolism, can affect total serum bilirubin and physiological jaundice in the newborn: low weight, ABO incompatibility, sepsis, breast feeding, smoking mother, exposure to light, birth season, administration of drugs to the mother before delivery, use of oxytocin to induce delivery [7,15]. Our study obviously is unable to take into account all these factors.…”

“…About the effects of epidural anesthesia with bupivacaine on neonatal bilirubin production, clinical studies are contradictory and no causative connection between bupivacaine and neonatal jaundice has yet been found [15][16][17][18].…”