Intramuscular adrenaline does not reduce the incidence of respiratory distress and hypoglycaemia in neonates delivered by elective caesarean section at term.

Abstract

Aim: To test whether intramuscular injection of 30 µg adrenaline reduces the incidence of respiratory distress and hypoglycaemia in term infants delivered by elective caesarean section before onset of active labour.

Method: The study was randomised and double-blinded. A total of 270 neonates were assigned to intramuscular treatment with saline (0.30 ml) or 30 µg adrenaline (0.30 ml) immediately after birth. The primary end-point was referral to the neonatal unit because of respiratory distress or a blood glucose < 1.8 mmol/l measured two hours after birth. The first 50 infants enrolled were monitored for potential side effects with pulse oximetry.

Results: Pulse-oximetry recordings revealed a modest systemic effect of intramuscular adrenaline, the heart rate and haemoglobin oxygen saturation being significantly higher in infants who received adrenaline. The incidence of respiratory distress or hypoglycaemia was 14% among infants who received adrenaline compared with 7% in the control group (p=0.048).

Conclusion: Intramuscular injection of 30 µg adrenaline does not reduce the incidence of respiratory distress or hypoglycaemia after elective caesarean