Antepartum: Initiation or improvement of uterine contractions in order to achieve early vaginal delivery; induction of labour in patients w/ a medical indication for the initiation of labour (eg, Rh problems); maternal diabetes, pre-eclampsia at or near term; stimulation of reinforcement of labour. Adjunctive therapy in the management of incomplete or inevitable abortion. Postpartum: To produce uterine contractions during 3rd stage of labour & control postpartum bleeding or hemorrhage.
Induction or stimulation of laborIV (Drip method) Initial dose: 1-2 mU/min. Control of postpartum uterine bleedingIV (Drip method) 10-40 u/1000 mL. IM 10 u after delivery of placenta. Treatment of incomplete or inevitable abortionIV 10 u at a rate of 20-40 drops/min.
View Evatocin overdosage for action to be taken in the event of an overdose.
Contraindications
Significant cephalopelvic disproportion. Unfavorable fetal position. Obstet emergencies which favors surgical intervention, fetal distress where delivery is not imminent, hyperactive or hypertonic uterus. Cases where vag delivery is contraindicated.
Overstimulation of the uterus, hypertonicity or tetanic spasm. Fetal distress, partial placenta previa, prematurity, borderline cephalopelvic disproportion & any condition w/ predisposition for uterine rupture (eg, major surgery on the cervix or uterus including caesarean section, over distention of uterus, grand multiparity or past history of uterine sepsis or of traumatic delivery). Possibility of water intoxication. Evaluate for pelvic inadequacy & maternal & fetal conditions prior to therapy. Use of parenteral oxytocic drugs for induction of labour or for augmentation in the 1st & 2nd stages of labour. Administer by IV route only & w/ medical supervision when given for the induction of labour or augmentation of uterine activity.
In the mother: Anaphylactic reaction, postpartum hemorrhage, cardiac arrhythmia, fetal afibrinogenemia, nausea, premature ventricular contractions, pelvic hematoma, water intoxication w/ convulsions & coma. In infant: Due to induced uterine motility: Fetal death, bradycardia, arrhythmia & permanent CNS or brain damage; Due to use of oxytocin in the mother: Low Apgar scores in 5 min, neonatal jaundice & hemorrhage.
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