ABSTRACT

Hyperbilirubinemia, is the most common problem in term newborns. Studies on neonatal hyperbilirubinemia and the use of oxytocin for the induction of labor have conflicting results, but it has been widely accepted that oxytocin infusion during labor, increased the risk of neonatal hyperbilirubinemia. When searched at Medline for misoprostol and neonatal hyperbilirubinemia, which is nowadays more frequently as a labor induction agent, we were not able to find any study about this case. We aimed to investigate and compare the effect of oxytocin and misoprostol on neonatal bilirubin levels with spontaneous vaginal delivery.

We included 89 patients who have delivered at the Baskent University Obstetrics and Gynecology Department. There were 34 patients in the spontaneous vaginal delivery group (control group), and 23 and 32 patients in the oxytocin and misoprostol group, respectively. Cord blood sodium and hematocrit levels, and postpartum day 2 and 4 bilirubin levels were measured.

Parity, maternal body mass index, gestational age, birth weight, sex distribution, and frequency of using epidural analgesia for labor were similar in the three groups. Cord blood sodium and hematocrit levels were not statistically different between the groups. The mean of bilirubin levels on day 2 and 4 in the control, oxitocin and misoprostol groups were 8.93 ± 3.90 - 10.40 ± 5.52 mg/dL, 9.93 ± 3.71- 12.32 ± 4.32 mg/dL, and 8.32 ± 3.48 - 9.91 ± 4.57mg/dL, respectively. Postpartum 2nd and 4th day bilirubin levels were not statistically different between the groups (p<0.05).

We found no difference between labor induction with misoprostol or oxytocin in regard of neonatal hiperbilirubinemia. This finding might encourage the use of misoprostol, with it’s advantages of low cost, stability in relation to temperature, easy handling and storage, and easy administration.

Keywords: Misoprostol, oxytocin, neonatal hyperbilirubinemia