Oxytocin application routine
I. Indications.
1, planned delivery in line with normal fetal heart sounds and fetal position, no obvious cephalopelvic disproportion;
2, coordinated contraction weakness (including primary and secondary) in line with the above conditions;
3.Stillbirth, abnormal fetus with normal fetal position and no obvious cephalopelvic disproportion.
Contraindications.
1.Obvious cephalopelvic disproportion;
2.Severe cardiopulmonary insufficiency;
3. Scarred uterus, post hysterectomy, post hysterectomy of horn pregnancy;
4, abnormal fetal position, such as transverse position, compound previa, etc;
5, intrauterine distress or severe placental hypofunction;
6, uncoordinated uterine contraction weakness;
7, spastic uterine stenosis ring;
8, pelvic stenosis and soft birth canal obstruction;
9, history of oxytocin allergy.
Third, caution with.
1, excessive elongation of the uterine body (huge children, excessive amniotic fluid, multiple pregnancies) without rupture of the membranes;
2, breech position;
3, multiparity, advanced maternal age;
Before using oxytocin, vaginal examination, cervical Bishop score and pelvic stenosis should be performed.
V. Method of use (infusion pump).
Firstly, adjust 8 drops/min, add 2.5U of oxytocin into 500ml of 5% G.S, so that each drop of sugar solution contains 0.33U of oxytocin, increase 5 drops/min every 15~30 minutes from 8 drops/min, maintain contractions for 30~40 seconds/3~5 minutes, uterine pressure above 50~60mmHg, interval between contractions cannot be less than 1 minute, record every 15~30 minutes Record one contraction and fetal heartbeat, most of the drops to 40 drops/min can enter regular contractions, if not effective, increase the concentration of oxytocin within 1%, up to 40 drops/min, the concentration of oxytocin can be 1% when contractions are weak.
Six, immediate discontinuation of oxytocin indications.
1.Uterine rupture of aura or signs of uterine rupture: unexplained vaginal bleeding and sudden acceleration of pulse, slow or absent fetal heart sounds, hematuria, pathological contraction ring, sudden weakening or disappearance of contractions;
2, contractions too strong, too frequent, spasmodic contractions;
3, transient hypotension;
4, allergic reactions: chest tightness, shortness of breath, irritability, chills, urticaria, shock;
5.Fetal heart rate monitoring suggests intrauterine distress;
6, suspected amniotic fluid embolism.
Seven, precautions.
1, induction of labor can only be static drops, not intramuscular injection, cavity injection or mucosal administration: the sensitivity threshold of oxytocin individual differences, try to control the number of drops with an infusion pump, and a person to look after, continuous fetal heart monitoring until delivery.
2.After reaching the effective concentration, adjust the number of drops according to the contractions in time to maintain effective contractions;
3, such as the day of induction of labor to 17:00 unsuccessful, should stop the induction of labor, so that the mother rest, and continue the next day, three consecutive days of induction of labor is not effective as induction of labor failure;
4, to stop the use of oxytocin still contractions can not be relieved, available 25% MgSO4 16ml plus 5% Glu 10ml static push (5 minutes);
5.If oxytocin allergy occurs, stop using it immediately and provide anti-allergy treatment;
6.Pay attention to labor monitoring, dilation of the uterus, previa, fetal heartbeat, maternal blood pressure, pulse rate, urine output, etc;
7, daily intake ≤ 1000ml is appropriate to prevent poisoning (oxytocin has similar antidiuretic hormone effect), large doses of oxytocin can cause increased blood pressure, water retention, etc. Routinely use 5% G.S.