Effect of different Analgesic modalities during normal labor on changes in peripheral leucocytic counts and interleukin - 2 and - 6 serum concentrations in healthy parturients

ABSTRACT

Many analgesic techniques are nowadays applied during labor; each has its own advantages and drawbacks. Little has been reported about the immunologic impact of analgesia during labor. Many immunologic changes occurring during labor may be affected by pain relief. Cytokines such as IL-2 and IL-6 and white blood cell count may give a clue about such immunologic changes during labor. Thirty parturients in labor were investigated and divided into 3 equal groups according to the analgesia offered during labor epidural group I, pethidine group II, and N2O group III. The results revealed good analgesic outcome and fetal profile in group I whereas fetal outcome in group II was the worst. IL-2 was lowest in cord blood of group I while it increased in both cord blood and postpartum samples in group III.IL-6 increased in cord blood in group I and II and decreased at cervical full dilatation in group I and III. Leucocytosis was significantly increased in group I and II with neutrophilia specially at full cervical dilatation. Cord blood showed neutropenia in group II cord blood. Lymphocytosis was highest in group II while lymphopenia was significant in cord blood of group I.The present study showed that epidural analgesia during labor offered good labor milieu regarding pain relief and neonatal outcome with better immunological condition.Nitrous oxide had significant immunosuppressive effect, while pethidine did not show any significant immunologic impact during spontaneous labor. Further studies are recommended to include more immune parameters and to establish reference values for assessment of peripartum immunologic status for both mother and newborn during labor under different analgesic techniques