Use of oxytocin and misoprostol for induction or ... - POPPHI

Comment Setting Country Source and date
need for guidelines hospital et al., 2007(13)
Women who cannot afford elective CS, choose
elective induction, only those who are very poor
have no interventions
hospital Brazil Behague D, 2002
(14)
10% rate of elective induction hospital Fiji Saunders D and
Makutu S, 2001(15)
A qualitative study in Bangladesh documents cases
where physicians recommend Cesarean delivery to
women or couples who prefer vaginal delivery.
After the physician leaves the room, a nurse offers a
normal delivery for a small payment. After
receiving payment, the nurse administers IV fluid to
the woman, who delivers vaginally later in the day.
hospital Bangladesh Parkhurst J, and
Rahman, 2007(16)
39 cases of maternal deaths were directly caused by
incorrect use of oxytocin in Fujian Province, from
1986 to 1992. Main reason was the ignorance of the
birth attendants on correct use of oxytocin. 90% of
these deaths occurred in the rural and mountainous
areas at patients homes or on the way to hospital.
IM injections of oxytocin by the traditional birth
attendant during labor in indigenous communities in
rural areas were significantly associated with
intrapartum deaths.
Rural,
community
Rural,
indigenous
community
China
Guatemala
Zheng Q and Zhang
X, 1994 (17)
Bartlett A and Paz de
Becaletti M, 1991(5)
Cervical ripening, induction and augmentation of labor all involve the use of uterotonic
drugs. The gold standard for induction protocols in high resource settings (HRS) is
cervical ripening with a vaginal prostaglandin such as Prostin E2 (or dinoprostone)
followed, if needed, by induction or augmentation with IV oxytocin and incorporating
artificial rupture of the membranes (ARM) depending on the clinical situation of the
woman (18-21). In HRS with adequate guidelines, training, monitoring practices,
equipment and staffing, induction and augmentation are very safe and effective
interventions for indications such as, but not limited to; post-date pregnancy, intrauterine
growth restriction of the fetus or uncontrolled hypertension (22, 23).
Although the benefits associated with the use of uterotonics are firmly established in the
third stage of labor (3)(24), the frequency with which oxytocin and misoprostol should be
used for induction and augmentation of labor is controversial in LRS. In such settings,
the only uterotonic drugs available at peripheral centers in most cases are oxytocin,
ergometrine and misoprostol. However prostoglandin vaginal gel can be commonly
12