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    SDMS ID: P2010/0482-001 2.7-07WACS Title: Oxytocin (Syntocinon) Infusion

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    Ywagar Ywagar
    This document provides guidelines for the use of oxytocin infusion for induction and augmentation of labor. It outlines appropriate dosing protocols for both primiparous and multiparous women. Precautions are noted for women with prior uterine scars or high parity. Guidelines describe starting doses, incremental increases, maximum doses, and criteria for hyperstimulation. Fetal and maternal monitoring protocols are also specified.

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    SDMS ID: P2010/0482-001 2.7-07WACS Title: Oxytocin (Syntocinon) Infusion

    Uploaded by

    Ywagar Ywagar
    181 views5 pages
    This document provides guidelines for the use of oxytocin infusion for induction and augmentation of labor. It outlines appropriate dosing protocols for both primiparous and multiparous women. Precautions are noted for women with prior uterine scars or high parity. Guidelines describe starting doses, incremental increases, maximum doses, and criteria for hyperstimulation. Fetal and maternal monitoring protocols are also specified.

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    Oxytocin

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    This document provides guidelines for the use of oxytocin infusion for induction and augmentation of labor. It outlines appropriate dosing protocols for both primiparous and multiparous women. Precautions are noted for women with prior uterine scars or high parity. Guidelines describe starting doses, incremental increases, maximum doses, and criteria for hyperstimulation. Fetal and maternal monitoring protocols are also specified.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    181 views5 pages

    SDMS ID: P2010/0482-001 2.7-07WACS Title: Oxytocin (Syntocinon) Infusion

    Uploaded by

    Ywagar Ywagar
    This document provides guidelines for the use of oxytocin infusion for induction and augmentation of labor. It outlines appropriate dosing protocols for both primiparous and multiparous women. Precautions are noted for women with prior uterine scars or high parity. Guidelines describe starting doses, incremental increases, maximum doses, and criteria for hyperstimulation. Fetal and maternal monitoring protocols are also specified.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 5

    SDMS ID: P2010/0482-001 2.

    7-07WACS Title: Replaces: Description: Target Audience: Key Words: Policy Supported: Oxytocin (Syntocinon) Infusion Syntocinon Infusion Regime for Induction and Augmentation of Labour Oxytocin infusion for induction and augmentation of labour Midwives and medical staff, QVMU Oxytocin P2010/0528-001Uterine Hyperstimulation P2010/0486-001Intrapartum Fetal Monitoring Objective: To establish uterine activity that is sufficient to produce cervical change and fetal descent while avoiding hyperstimulation. Precautions Prior to Commencing Oxytocin Oxytocin should be used with caution and only after discussion with a Consultant in a woman with a previous uterine scar and/or of high parity (greater than four). Oxytocin should not be started for six hours following administration of vaginal prostaglandin E2 (Prostin) and thirty minutes following removal of Cervidil. Ensure there are no fetal heart rate abnormalities. In women with intact membranes, amniotomy should be performed prior to commencement of an infusion of oxytocin. Dose: 10 units of Oxytocin (Syntocinon) in 1000 ml of Hartmanns solution (concentration of 10 milliunits per 1ml). Administration: Oxytocin infusion should be administered via an infusion pump and piggy-backed to the main IV line and as close to the IV cannula site as possible. Infusion Rate: The dose of oxytocin should be titrated against uterine contractions. The aim is to achieve a frequency of one contraction every two and half to three minutes, lasting 60 seconds using the minimum dose of oxytocin possible. Primiparous Women Starting Dose 12ml/hr (2 milliunits/minute)

    Incremental Increase Increase infusion rate by 12ml/hr (2 milliunits per minute)to a maximum dose of 120ml/hr (20 milliunits/min)
    1

    Dosage Interval Every 30 minutes

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    Once maximum dose has been running for 30 minutes the consultant or registrar should review the woman prior to higher doses being administered. The overall maximum dose of oxytocin should not exceed 216ml/hr (36mU per minute)

    Multiparous Women The registrar or consultant will determine the starting and incremental rate for multiparous women. It may be appropriate to start the infusion at 6 ml/hr (1mU/min) and increased by 6 ml/hr (1 mU/min) every 30 minutes to a maximum dose of 120ml/hr (20mU/min). Once maximum dose has been running for 30 minutes the consultant or registrar should review the woman prior to higher doses being administered. Observations Continuous electronic fetal monitoring should be initiated (as per Intrapartum Fetal Monitoring WACSClinProc2.3). Half hourly observations of maternal pulse, contractions and liquor. Maternal blood pressure second hourly and temperature four hourly. Vaginal examination should be done four hourly when contractions establish to assess the progress of labour. Monitor fluid balance. All observations, including infusion rate, should be documented on the partogram. Uterine Hyperstimulation Uterine hyperstimulation is defined as: 5 or more contractions in 10 minutes and/or Contractions lasting 2 minutes. Management of Uterine Hyperstimulation without Fetal Compromise Decrease the oxytocin infusion rate by half. Monitor to identify whether further intervention required. Management of Uterine Hyperstimulation with Fetal Heart Rate Abnormalities Cease oxytocin infusion Management as per P2010/0528-001Uterine Hyperstimulation Attachments Attachment 1 Attachment 2

    Oxytocin Infusion - Concentrations References

    Performance Indicators: Evaluation of compliance with guideline to be achieved through medical record audit annually by clinical Quality improvement Midwife WACS Review Date: Annually verified for currency or as changes occur, and reviewed every 3 years via Policy and Procedure working group coordinated by the Clinical and Quality improvement midwife. November 2009

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    Stakeholders: Developed by:

    Midwives and medical staff WACS Dr A Dennis Co-Director (Medical) Sue McBeath Co-Director (Nursing & Midwifery) Womens & Childrens Services

    Dr A Dennis Co-Director (Medical) Womens & Childrens Services

    Sue McBeath Co-Director (Nursing & Midwifery) Womens & Childrens Services

    Date: _________________________

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    ATTACHMENT 1 OXYTOCIN INFUSION - CONCENTRATIONS 10 units Oxytocin in 1000 ml Hartmanns Solution Infusion Rate Milliunits/minute 12 ml/hr 2 mU/min 24 ml/hr 4 mU/min 36 ml/hr 6 mU/min 48 ml/hr 8 mU/min 60 ml/hr 10 mU/min 72 ml/hr 12 mU/min 84 ml/hr 14 mU/min 96 ml/hr 16 mU/min 108 ml/hr 18 mU/min 120 ml/hr 20 mU/min Consultation with registrar or consultant required prior to higher doses being given. 132 ml/hr 22 mU/min 144 ml/hr 24 mU/min 156 ml/hr 26mU/min 168 ml/hr 28 mU/min 180 ml/hr 30 mU/min 192 ml/hr 32 mU/min 204 ml/hr 34 mU/min 216 ml/hr MAXIMUM INFUSION RATE 36 mU/min MAXIMUM INFUSION RATE

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    ATTACHMENT 2 REFERENCES Frigoletto F 2006 Active management of labour Online: http://www.uptodateonline.com/utd/content/topic.do?topicKey=labordel/2820&view=print King Edward Memorial Hospital 2003 Clinical Guidelines: 5.1 Induction of labour Online: http://www.kemh.health.wa.gov.au/development/manuals/sectionb/index.htm#5 National Institute of Clinical Excellence (NICE) 2006 Draft Guidelines for Intrapartum Care Online: http://www.nice.org.uk/page.aspx?o=guidelines.inprogress.intrapartumcare Pairman S, Pincombe J, Thorogood C, Tracy S, Midwifery preparation for practice 2006 Elsevier Australia RCOG Induction of Labour Evidence-based Clinical Guideline Number 9, 2001 Online: http://www.rcog.org.uk/index.asp?PageID=697 Satin A 2006 Abnormal labour: Protraction and arrest disorders Online: http://uptodateonline.com/utd/content/topic.do?topicKey=labordel/4449&view=print UpToDate 2007 Oxytocin: Drug information Online: http://uptodateonline.com/utd/content/topic.do?topicKey=drug_1_z/190133&view=print

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