adverse effects of ptocin (3)
water intoxication
uterine rupture
sinus bradycardia
DOC to induce labor at term
pitocin
effects of oxytocin (3)
causes timed contractions
prevention of hemorrhage
stimulation of milk let-down
ergot alkaloids (2)
Ergonovine maleate (Ergotrate) Methylergonovine maleate (Methergine)
ergot alkaloids uses
after completion of labor and delivery of the placenta to produce firm contractions & decrease uterine bleeding
2nd line after massage and oxytocin
ergot alkaloid MOA
contraction of uterine smooth muscle through activation of serotonin and a-adrenergic receptors
ergot alkaloid contraindications (2)
never used to induce labor- risk of fetal hypoxia
obliterative vascular or coronary artery disease
dinoprostone (Prostin E2) indications/effects (2)
expulsion of uterine contents
cervical ripening prior to delivery at term
prostaglandin contraindications (many)
acute pelvic inflammation
acute pulm., cardiac, renal, or hepatic disease
asthma, HTN, anemia, jaundice, or epilepsy
carboprost tromethamine (Prostin M15/Hemabate) uses (2)
induce abortion in 2nd trimester
postpartum bleeding due to uterine atony (3rd line)
uterine relaxants (tocolytics) (3)
Magnesium sulfate
Nifidipine
Indomethacin
1st line tocolytic
Magnesium sulfate
tocolytic used as prophylaxis
progesterone
emergency tx of uterine rupture
Nitroglycerin
1st line treatment for postpartum hemorrhage
massage
biggest risk factor for pre-term labor
previous pre-term labor
