Effects of oxytocin in different solutions on cord plasma bilirubin levels: systematic review


  • Pimprapa Muenpirom Roi Et Hospital, Thailand
  • Kittiphum Vejsitthangkul Udon Thani Hospital, Thailand
  • Khakhanang Chantarayotha Khon Kaen Hospital, Thailand
  • Benjaporn Namyotee Khon Kaen Hospital, Thailand.



To identify the effects of oxytocin in different solutions on cord plasma bilirubin levels.


We searched systematically for studies through PubMed, the Cochrane Library, Scopus, Clinicaltrials.gov, Trip Database and Google Scholar as well as hand-searching to identify relevant randomized controlled trials (RCTs) that compared the cord plasma bilirubin levels of solutions of oxytocin infusion in 5% glucose in water and in 0.9% NaCl solution as the primary outcome. The secondary outcomes included their effects on neonatal plasma bilirubin levels day 2-3 and cord plasma sodium levels.


We identified and included two RCTs with 269 full-term pregnant women with singleton pregnancy. Cord plasma bilirubin levels was not significantly different between using oxytocin in either 5% glucose in water or 0.9% NaCl solution (mean difference (MD), -0.03; 95% confidence interval (CI) [-0.52 to 0.46], I2=93%). Neonatal plasma bilirubin levels in day 2-3 was also not significantly different between using oxytocin in either 5% glucose in water or 0.9% NaCl solution (MD, 0.27; 95% CI, [-1.59 to 2.13], I2=97%). Cord plasma sodium levels of using oxytocin in 5% glucose in water was significantly lower than that of in 0.9% NaCl solution group (MD, -2.00; 95% CI, [-3.57 to -0.44], I2=95%).


There was no statistically significant difference in cord plasma bilirubin levels between using oxytocin in 5% glucose in water and in 0.9% NaCl solution.


Labor induction - Mayo Clinic [Internet]. [cited 2016 Jul 7]. Available from: http://www.mayoclinic.org/tests-procedures/labor-induction/basics/definition/prc-20019032

ACOG Committee on Practice Bulletins -- Obstetrics. ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol 2009; 114:386.

Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, et al. Births: final data for 2006. Natl Vital Stat Rep 2009;57:1–102. (Level II-3)

Methods for Cervical Ripening and Induction of Labor - American Family Physician [Internet]. [cited 2016 Jul 16]. Available from: http://www.aafp.org/afp/2003/0515/p2123.html

V M Buckalew Jr, Gruber and KA. Natriuretic Hormone. Annual Review of Physiology. 1984;46(1):343–58.

Oscarsson ME, Amer-Wåhlin I, Rydhstroem H, Källén K. Outcome in obstetric care related to oxytocin use. A population-based study. Acta Obstet Gynecol Scand. 2006;85(9):1094–8.

Stanton C, Armbruster D, Knight R, Ariawan I, Gbangbade S, Getachew A, et al. Use of active management of the third stage of labour in seven developing countries. Bull World Health Organ. 2009 Mar;87(3):207–15.

Pitocin (oxytocin) dosing, indications, interactions, adverse effects, and more [Internet]. [cited 2016 Jul 16]. Available from: http://reference.medscape.com/drug/pitocin-oxytocin-343132#0

Pitocin (Oxytocin Injection) Drug Information: Medication Guide and Patient Information - Prescribing Information at RxList [Internet]. RxList. [cited 2016 Jul 16]. Available from: http://www.rxlist.com/pitocin-drug/medication-guide.htm

Postpartum Haemorrhage, Prevention and Management (Green-top Guideline No. 52) [Internet]. Royal College of Obstetricians & Gynaecologists. [cited 2016 Jul 16]. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg52/

Minchom P, Niswander K, Chalmers I, Dauncey M, Newcombe R, Elbourne D, et al. Antecedents and outcome of very early neonatal seizures in infants born at or after term. BJOG: An International Journal of Obstetrics & Gynaecology. 1987 May 1;94(5):431–9.

Schwartz RH, Jones RW. Transplacental hyponatraemia due to oxytocin. Br Med J. 1978 Jan 21;1(6106):152–3.

Schoenfeld A, Buckman G, Nissenkorn I, Cohen S, Ben-Sira I, Ovadia J. Retinal hemorrhages in the newborn following labor induced by oxytocin or dinoprostone. Arch Ophthalmol. 1985 Jul;103(7):932–4.

Beazley JM, Alderman B. Neonatal hyperbilirubinaemia following the use of oxytocin in labour. Br J Obstet Gynaecol. 1975 Apr;82(4):265–71.

Chew WC, Swann IL. Influence of simultaneous low amniotomy and oxytocin infusion and other maternal factors on neonatal jaundice: a prospective study. Br Med J. 1977 Jan 8;1(6053):72–3.

Evans D. Neonatal jaundice. BMJ Clin Evid [Internet]. 2007 Jun 1 [cited 2016 Jul 5];2007. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943774/

Hyperbilirubinemia AS on N. Neonatal Jaundice and Kernicterus. Pediatrics. 2001 Sep 1;108(3):763–5.

Oxytocin 10 IU/ml Solution for infusion - Summary of Product Characteristics (SPC) - (eMC) [Internet]. [cited 2016 Jul 15]. Available from: https://www.medicines.org.uk/emc/medicine/30427

Pitocin - FDA prescribing information, side effects and uses [Internet]. [cited 2016 Jul 15]. Available from: https://www.drugs.com/pro/pitocin.html

UCLH Drug Guideline and Policy Documents [Internet]. [cited 2016 Jul 15]. Available from: http://www.uclhguide.com/public/guideline

Omigbodun AO, Akindele JA, Osotimehin BO, Fatinikun T, Fajimi JL, Adeleye JA. Effect of saline and glucose infusions of oxytocin on neonatal bilirubin levels. International Journal of Gynecology & Obstetrics. 1993 Mar 1;40(3):235–9.

Oral E, Gezer A, Çagdas A, Pakkal N. Oxytocin infusion in labor: the effect different indications and the use of different diluents on neonatal bilirubin levels. Arch Gynecol Obstet. 267(3):117–20.

Cochrane Handbook for Systematic Reviews of Interventions [Internet]. [cited 2016 Jul 9]. Available from: http://handbook.cochrane.org/

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009 Jul 21;339:b2700.

Tylleskär J, Finnström O, Leijon I, Hedenskog S, Rydén G. Spontaneous Labor and Elective Induction—a Prospective Randomized Study. Acta Obstetricia et Gynecologica Scandinavica. 1979 Jan 1;58(6):513–8.

Singhi S, Chookang E, Hall JSE, Kalghatgi S. Iatrogenic neonatal and maternal hyponatraemia following oxytocin and aqueous glucose infusion during labour. BJOG: An International Journal of Obstetrics & Gynaecology. 1985 Apr 1;92(4):356–63.

Lao TTH, Loong EPL, Chin RKH. Intrapartum fluid administration and sodium concentration in maternal and umbilical cord plasma. European Journal of Obstetrics & Gynecology and Reproductive Biology. 1987 Aug 1;25(4):271–6.




How to Cite

Muenpirom, P., Vejsitthangkul, K., Chantarayotha, K., & Namyotee, B. (2019). Effects of oxytocin in different solutions on cord plasma bilirubin levels: systematic review. The Clinical Academia, 43(1), 13–24. Retrieved from https://he02.tci-thaijo.org/index.php/theclinicalacademia/article/view/169029