Natural Products—the Secondary Metabolites by James R. Hanson

Abstract

4 groups of 30 primigravidas and their infants were studied prospectively. No patient with rhesus incompatibility was included in the study. The 4 groups went into labor in the following ways: 1) induced by intravenous oxytocin; 2) induced by intravenous prostagladin (PG)E2; 3) induced by extraamniotic PGE2; and 4) spontaneous labor. Mean infant bilirubin levels on day 5 were significantly higher (p.005 and p.025 respectively) for the 1st 2 groups than for the spontaneous group. Levels for the group whose labor was induced with extraamniotic PGE2 infusion were not significantly different from those in the 1st 2 groups or the spontaneous group. The mean serum-bilirubin level was significantly lower (p.025) after caesarean section than after assisted vaginal delivery. Serum-bilirubin levels were not affected by previous maternal use of oral contraceptives, maternal smoking, or methods of infant feeding. Serum bilirubin levels below 10 mg/100 ml. are considered within the normal phsyiological limits during the neonatal period. Measured by this criteria, 14, 10, 9, and 6 babies in groups 1-4 respectively had abnormally high levels. The difference between groups 1 and 4 was significant at the p.05 level. Mean Apgar scores were significantly lower for the babies whose mothers had induced delivery with extraamniotic PGE2 infusion. These results suggest that the observed hyperbilirubinemia may be due to interruption of pregnancy rather than to any direct drug effect. There is no evidence to suggest that such high bilirubin levels are harmful to the child in the long run.