Dexamethasone blocks aromatase and phospholipase A2 enzyme activities that are essentially involved in the formation of oestrogens and prostaglandins, the key chemicals to initiate parturition. The present study was undertaken to determine whether dexamethasone, a potent glucocorticoid, could prolong gestation and/or delay parturition in rats. Dexamethasone at 0.5 mg/rat/day from Day 19 through Day 21 of pregnancy consistently prolonged gestation. Only 36% of the pregnant rats had labour with an extended parturition time. Foetal mortality rate was also high. The remaining 64% pregnant rats that did not deliver showed intrauterine foetal death and resorption. Concomitant injection of oestradiol cyclopentylpropionate or prostaglandin F2 alpha on Day 19 effectively reversed the deleterious effects of dexamethasone. 100% of the pregnant rats had successful labour at term. The parturition time and foetal mortality rate were not different from controls. The results, therefore, indicate that an excess glucocorticoid that initiates parturition in sheep conversely prolongs gestation and delays parturition in rats.
The dexamethasone suppression test is a useful endocrinological test to diagnose Cushing's syndrome. However, its interpretation may be influenced by many factors such as stress, alcohol, failure to ingest the dexamethasone, altered metabolism, drug interaction and obesity. This report illustrates such an instance, whereby the result of the test was erratic due to the anti-tuberculous drug rifampicin. Rifampicin has been found to profoundly attenuate the biological effects of dexamethasone, probably by enhancing its metabolism in the liver. The exact mechanism of the drug interaction remains elusive, though induction of hepatic CYP3A4 enzyme complex is a possible mechanism. In a patient treated with rifampicin, the results of dexamethasone suppression tests thus have no diagnostic value and can be very misleading.