Medoxycin Special Precautions

Oxytocin should not be given where spontaneous labour or vaginal delivery are liable to harm either the mother or the fetus. This includes significant cephalopelvic disproportion or unfavourable presentation of the fetus, placenta praevia or vasa praevia cord presentation or prolapse, mechanical obstruction to delivery, fetal distress or hypertonic uterine contractions. It should not be used where there is a predisposition to uterine rupture, as in multiple pregnancy or high parity, polyhydramnios, or the presence of a uterine scar from previous caesarean section. Oxytocin should not be employed for prolonged periods in resistant uterine inertia, severe pre-eclampsia or severe cardiovascular disorders.
When given for induction or enhancement of labour particular care is needed in borderline cephalopelvic disproportion, less severe degrees of cardiovascular disease and in patients over 35 years of age or with other risk factors. Careful monitoring of fetal heart rate and uterine motility is essential so that dosage of oxytocin can be adjusted to individual response; the drug should be given by intravenous infusion, preferably by means of a syringe pump. Infusion should be discontinued immediately if fetal distress or uterine hyperactivity occur.
Over-vigorous labour should be avoided in cases of fetal death in utero, or where there is meconium-stained amniotic fluid.
The risk of water intoxication should be borne in mind, particularly when high doses of oxytocin are administered over a long time.