Labor and delivery:
Indications for PITOCIN:
Initiation or improvement of uterine contractions in vaginal delivery. Adjunct in abortion. Control of postpartum bleeding.
Induction of labor: individualize. Initially 0.5–1milliunit/minute (see literature); adjust by 1–2 milliunits/minute at 30–60 minute intervals. Usual max at term: 9–10 milliunits/minute. Bleeding: IV, see literature. IM: 10Units after delivery of placenta. Abortion: see literature.
In anteparum use: Cephalopelvic disproportion. Unfavorable fetal position. When surgical intervention necessary. Fetal distress if labor is not imminent. Unsatisfactory progress in presence of adequate uterine activity. Hyperactive or hypertonic uterus. Invasive cervical carcinoma, active herpes genitalis, total placenta previa, vasa previa, cord presentation or prolapse or other cases where vaginal delivery is contraindicated or if predisposition for uterine rupture exists.
Not for elective induction of labor.
Use only in presence of qualified personnel. Monitor intrauterine pressure, fetal heart rate, maternal blood pressure.
Avoid use within 4 hours of prophylactic vasoconstriction with caudal block anesthesia. Avoid cyclopropane anesthetics.
Maternal: anaphylaxis, postpartum or subarachnoid hemorrhage, arrhythmias, fatal afibrinogenemia, nausea, vomiting, premature ventricular contraction, pelvic hematoma, water intoxication, hypersensitivity resulting in uterine hypertonicity, spasm, tetany, or rupture. Fetal: bradycardia, arrhythmias, CNS damage, seizure, low Apgar scores, jaundice, retinal hemorrhage, death.
Single-dose vial (1mL)—25; Multi-dose vial (10mL)—1, 25