Class:                                                                                                
Oxytocic
Synthetic pitutitary hormone

Action:
Stimulates uterine contraction to assist with control of postpartum bleeding or atony.

Indications:
Postpartum hemorrhage with “Clinical Triggers for Intervention”

• Heart rate greater than or equal to 110 bpm
• Blood pressure less than or equal to 85/45 or greater than 15% decrease from baseline
• Oxygen saturation less than 92%
• Signs/symptoms of anemia

(Other ante/peripartum indications not appropriate for use during inter-facility transport)

Definitions:

• General Obstetric Hemorrhage – cumulative blood loss greater than or equal to 1000 mL (includes intrapartum loss) or blood loss accompanied by signs and symptoms of hypovolemia within 24 hours following the birth process.  Cumulative blood loss of 500-999 mL should trigger increased assessment and potential interventions as clinically indicated.
• Massive Obstetric Hemorrhage – greater than or equal to 1500 mL blood loss for any birth

Precautions:
Hypersensitivity
Incomplete delivery of all products of gestation (3rd stage of labor)
Hypertension / PIH
Rapid infusion may lead to hypotension and dysrhythmias

Contraindications:
Uterine rupture
Incomplete delivery

Adult Dosing:

Bolus: Practicing AMTSL (active management of the third stage of labor): after delivery of the infant and cord is clamped, oxytocin (Pitocin) 30u in 500 mL NS will be infused at bolus rate via infusion pump (900 mL/hour)

Intravenous Infusion:  To control postpartum bleeding, Mix 40 units to 1000ml NS and infuse at 200 ml/hr for dose of 8 units/hr and run at a rate necessary to control uterine atony