Zeitschrift für Neonatalbiologie

Abstrakt

Maternal use of local anesthetic can cause methemoglobinemia in newborns: A case series

Samt-Balasubramaniam

Methemoglobinemia occurs when the methemoglobin concentration in red blood cells exceeds 1%. Acquired methemoglobinemia is more common than congenital and may occur after exposure to certain oxidative drugs. In our hospital, 8 infants were diagnosed with methemoglobinemia in 48,000 births over an 8-year period (2009–2017), including 6 cases of acquired methemoglobinemia. The infants presented with darkness, low oxygen saturation (74–90%), but normal/high arterial oxygen partial pressure (9.2–18.7 kPa). They had normal glucose-6-phosphate dehydrogenase levels (checked in 4 infants) and normal echocardiograms. One infant, born at term, developed necrotizing enterocolitis requiring surgical intervention. Five infants received and responded to methylene blue treatment. A case study of five infants found that the mother was given a local prilocaine injection during labor for episiotomy. Prilocaine can cause methemoglobinemia. The incidence of neonatal methemoglobinemia after prilocaine for episiotomy is estimated at 0.37% (1).