The Use of Oxytocics

The Use of Oxytocics

Oxytocin or syntocinon is the first line agent to help contract the uterus after delivery of the placenta. It can be administered as a bolus dose of 5 units slowly IV or 30 units/litre in normal saline or Hartmann’s over 4 hours. This is usually effective. However, occasionally ergometrine (0.2mg IM or IV) may be required. Ergometrine is a second line agent. It can elevate blood pressure and therefore should be used cautiously in severe pre-eclampsia. It produces nausea, vomiting and vasoconstriction which is hazardous in patients with pre-eclampsia.

The third line agents are prostaglandins, if available. Prostaglandin f2 alpha (250micrograms) injected intramyometrium is effective. Side effects include nausea, vomiting, diarrhoea and bronchoconstriction.