Properties
What is it?
International Nonproprietary Name - oxytocin Clinical-pharmacological group: Obstetrics, Gynecology → Agents for increasing myometrial tone and contractility → Oxytocin, its analogues and derivatives Qualitative and quantitative composition Each ampoule contains: 1 ml of solution – 5 IU oxytocin. Indications for use Oxytocin is used to stimulate uterine contractility. Indications for use during the prenatal period: Induction of labor Induction of labor for medical reasons in cases of post-term pregnancy, premature rupture of membranes, pregnancy-induced hypertension (preeclampsia). Enhancement of uterine contractility Intravenous administration is permissible during the first or second stage of labor to enhance contractions in cases of prolonged labor or absence or weakness of uterine contractions. Indications for use during the postpartum period: Prevention and treatment of uterine hypotonia to stop postpartum hemorrhage. During cesarean section, but after the delivery of the baby. Other indications for use: As adjuvant therapy in cases of incomplete and missed abortion. Method of administration and dosage It is not recommended to administer oxytocin within 6 hours of vaginal prostaglandin administration. The dose is determined considering the individual sensitivity of the pregnant woman and the fetus. The dosage information provided below is based on various treatment regimens and widely accepted parameters. For induction and stimulation of labor Oxytocin is administered only by intravenous drip infusion. Strict control of the recommended infusion rate is mandatory. For safe use of oxytocin during induction and labor augmentation, it is necessary to use an infusion pump or similar device, as well as to monitor uterine contractions and fetal heart function. In case of excessive enhancement of uterine contractility, the infusion should be immediately stopped, as a result, excessive uterine muscle activity rapidly decreases. 1. Before starting the administration of the drug, it is necessary to start the administration of physiological saline solution that does not contain oxytocin. 2. To prepare a standard infusion solution: the contents of 1 ampoule – 1 ml (5 IU) oxytocin should be dissolved under sterile conditions in 1000 ml of non-hydrated fluid and mixed properly by rotating the bottle. 1 ml of the infusion prepared in this way contains 5 IU of oxytocin. An infusion pump or similar device should be used for accurate dosing of the infusion solution. 3. The initial infusion rate should not exceed 0.5-4 milliunits per minute. It can be increased by 1-2 milliunits per minute every 20-40 minutes until the desired degree of uterine contractility is achieved. Upon achieving the desired frequency of uterine contractions (corresponding to spontaneous labor activity), in the absence of signs of fetal distress and with cervical dilation up to 4-6 cm, the infusion rate can be gradually reduced at a rate similar to its acceleration. Infusion at a high rate in late pregnancy requires caution; in rare cases, a rate exceeding 8-9 milliunits per minute may be necessary. In case of premature labor, a high rate may be required, which in isolated cases may exceed 20 milliunits per minute. 4. It is necessary to monitor fetal heart rate, resting uterine tone, frequency, duration, and strength of contractions. 5. In case of uterine hyperactivity or fetal distress, oxytocin infusion should be immediately discontinued. The parturient should be provided with oxygen therapy. The condition of the parturient and the fetus should be monitored by a specialist physician.
