الفهرس | Only 14 pages are availabe for public view |
Abstract -84- SUMMAR AND CONCLUSION Several studies have reported an increased incidence of neonatal jaundice following the use of oxytocin for induction or augmentation of labor. The mechanism of hyperbilirubinemia ,was investigated and contradictory results were reported. Some authors reported that the use of oxytocin for induction of labor is usually associated with liver immaturity, anoxic liver’ damage, enhanced placentofetal transfusion and increased red blood cell fragility. The effect of electrolyte free solutions as glucose 5% alone or with oxytocin on serum sodium and serum bilirubin levels was controversial. Some reports suggested that hyponatraemia was accompanied by an increased incidence of neonatal hyperbilirubinaemi.a. The present work consisted of 120 cases sUbjected to labor augmentation. They were divided into 4 equal groups each including 30 cases. The 4 groups were comparable as regards maternal age, parity, gestational age and the newborns wer~ comparable as regards birth weight and one minute Apgar score. The dose of oxytocin was the same in all cases (10 units). The first group received less than 500 cc normal saline, the second group received more than 1000 cc normal saline, the third group received less than 500 cc glucose 5% and the fourth group received more than 1000 cc glucose 5%. -B5- The study showed an increased incidence of neon~tal hyponatraemia in the cases received 1000 cc and highly significant maternal and cord serum sodium levels glucose 5% more than correlation between in all groups (P <0.01). There is also a significant between neonatal serum sodium and negative correlation serum bilirubin (P <0.01) with an increased incidence of neonatal hyperbilirubinaemia among hyponatraemic group. Jaundice among cases who have normal serum sodium and those received salt containing solution (normal saline) during labor may be attributed to other mechanism of actioR of oxytocin. It is found that the use of electrolyte containing solution as normal saline 0.9% and the use of glucose 5% in volumes less than 500 cc during labor is attended with a lower incidence of neonatal hyponatraemia and hyperbilirubinaemia. |