Neonatal serum bilirubin levels following the use of prostaglandin E2 in labour

The effect of oxytocin infusion and misoprostol on neonatal bilirubin levels

PURPOSE

To investigate the association of neonatal bilirubin levels with oxytocin and misoprostol use for labour induction.

METHODS

A total of 100 neonates were included in the study. The first group consisted of 50 healthy babies of women who had received oxytocin infusion and the second group consisted of 50 healthy babies of women who had received 25 μg misoprostol every 4 h placed in the posterior fornix for labour induction. Bilirubin and haematocrit levels were measured in all on days 1 and 4 of the neonatal period.

RESULTS

The levels of bilirubin in the oxytocin group were significantly higher than those in the misoprostol group on day 1 [4.42 ± 0.27 mg/dl versus 3.55 ± 0.28 mg/dl (P = 0.035)] while they were higher also on day 4 but was not significantly so [7.47 ± 0.63 mg/dl versus 6.86 ± 0.65 mg/dl (P = 0.525)]. The mean haematocrit levels on day 1 were 50.62 ± 1.23 and 58.04 ± 1.30 in groups 1 and 2, respectively, with a significant difference between them. The levels were 52.31 ± 1.27 and 58.96 ± 1.14 on day 4 and the difference was again significant. P < 0.05 indicated statistical significance.

CONCLUSIONS

Labour induction with misoprostol and oxytocin does not seem to have harmful effects on bilirubin levels in the neonate.

The effect of oxytocin infusion and misoprostol on neonatal bilirubin levels

PURPOSE

To investigate the association of neonatal bilirubin levels with oxytocin and misoprostol use for labour induction.

METHODS

A total of 100 neonates were included in the study. The first group consisted of 50 healthy babies of women who had received oxytocin infusion, and the second group consisted of 50 healthy babies of women who had received 25 microg misoprostol every 4 h placed in the posterior fornix for labour induction. Bilirubin and haematocrit levels were measured in all on days 1 and 4 of the neonatal period.

RESULTS

The levels of bilirubin in the oxytocin group were significantly higher than those in the misoprostol group on day 1 [4.42 +/- 0.27 vs. 3.55 +/- 0.28 mg/dl (P = 0.035)] while they were higher also on day 4 but not significantly so [7.47 +/- 0.63 vs. 6.86 +/- 0.65 mg/dl (P = 0.525)]. The mean haematocrit levels on day 1 were 50.62 +/- 1.23 and 58.04 +/- 1.30 in groups 1 and 2, respectively, with a significant difference between them. The levels were 52.31 +/- 1.27 and 58.96 +/- 1.14 on day 4 and the difference was again significant. P < 0.05 indicated statistical significance.

CONCLUSIONS

Labour induction with misoprostol and oxytocin does not seem to have harmful effects on bilirubin levels in the neonate.

Transcutaneous bilirubin levels in the first 96 hours in a normal newborn population of > or = 35 weeks' gestation

OBJECTIVE

To obtain transcutaneous bilirubin (TcB) measurements, at 6-hour intervals, in the first 96 hours after birth in a normal newborn population (gestational age: > or =35 weeks).

METHODS

We performed 9397 TcB measurements on 3984 healthy newborn infants (gestational age: > or =35 weeks) from 6 to 96 hours of age. All measurements were performed in the well-infant nursery with a Draeger Air-Shields transcutaneous jaundice meter (model JM-103), within 2 hours of the designated time.

RESULTS

There was a distinct pattern to the velocity of the increase in TcB levels over different time periods. TcB levels increased in a linear manner most rapidly in the first 6 to 18 hours and then less rapidly from 18 to 42 hours, followed by a much slower increase until peak levels occurred. Decreasing gestational age was associated significantly with higher TcB levels.

CONCLUSIONS

We provide data on neonatal bilirubinemia, based on TcB levels determined in a large, predominately white and breastfed, North American population. Infants who require closer evaluation and observation initially are those whose bilirubin levels are > or =95th percentile, ie, increasing more rapidly than 0.22 mg/dL per hour in the first 24 hours, 0.15 mg/dL per hour between 24 and 48 hours, and 0.06 mg/dL per hour after 48 hours. These data should be useful for detecting aberrant trends, identifying infants who need additional evaluation, and planning appropriate follow-up for jaundiced newborns.