Oxytocin (Pitocin, Syntocinon)

Category:

  • Hormone

Description:

  • Pituitary hormone

Indications:

  • Induction of labor

  • Augmentation of labor

  • Control of postpartum uterine bleeding

  • Treatment of incomplete of inevitable abortion  

Contraindications:

  • Significant, known, cephalopelvic disproportion

  • Unfavorable fetal position or presentation which are undeliverable without conversion prior to delivery

  • Cases where vaginal delivery is contraindicated (invasive cervical carcinoma, active genital herpes, total placenta previa or vasa previa)

  • Obstetrical emergencies where the risk-to-benefit ratio of maternal and fetal safety favors surgical intervention

  • Cases of fetal distress where delivery is not imminent

  • Prolonged use in uterine inertia or severe toxemia

  • Hypertonic or hyperactive uterine patterns

Precautions:

  • Stimulates uterine contractions similar to normal labor.

  • Overstimulation may harm mother and fetus.

  • Oxytocin has an intrinsic antidiuretic effect and may lead to water intoxication when administered in large or prolonged doses.

Adverse Reactions (Side Effects):

  • Maternal:

    • anaphylactic reaction

    • cardiac arrythmia, PVCs

    • nausea, vomiting

    • water intoxication

    • uterine rupture

  • Fetal

    • bradycardia, PVCs, and other arrythmias

    • in the presence of significant, prolonged overstimulation of uterine contractions, may cause permanent brain damage and death

Dosage:

  • Administered by injection

  • Induction of labor: 

    • 0.001-0.002 units (1-2 mU) per minute, increase dose by 0.001-0.002 units (1-2 mU) every 15-30 minutes until contraction pattern has been established (generally no more than 0.02 units (20 mU) per minute

  • Control of postpartum uterine bleeding: 

    • 10-40 units run in 1000mL of IV fluids (blood, plasma or crystalloid) at a rate to control uterine atony or 10 units IM following placental delivery

  • Treatment of incomplete of inevitable abortion: 

    • 10 units in 1000ml IV fluid run at 0.01-0.02 units (10-20mU) [20-40 drops] per minute

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