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

More documents

Recommendations

Info

Term Definition minutes. See table 3.3a for doses and for comparison of high and low dose regimens. There seems to be consensus that there be at least six hours interval between last prostaglandin dose and first oxytocin dose(18-21). Preparations of oxytocin for electronic infusion vary as well, but consensus is to have a standard practice in each protocol to avoid confusion. To reduce the risks associated with excess IV fluid it is suggested by RCOG to mix 10 IU in 500ml of IV fluid for a concentration of 20,000mU/L. Preterm Generally defined between 24 and 37 weeks gestation. Term is between 37 and 42 weeks gestation. Postdates pregnancy is one that is one or two or more weeks past 40 weeks and is sometimes called prolonged pregnancy(18). Monitoring during induction of labor Any labor including an induced one should be monitored using a WHO approved partograph including pulse, blood pressure, contraction frequency, strength and length, pv. Blood loss and fetal heart rate(23). Fetal heart rate (FHR) should be monitored during an induction by external fetal monitor (EFM) or intermittent auscultation (IA) (22). Some guidelines suggest constant external fetal monitoring in places where such facilities exist (19, 20). Fetal distress Labor Other methods Hypertonus or hyperstimulati on of the uterus Signified by FHR abnormalities is ill defined (22) especially in low resource settings where electronic fetal monitoring (EFM) may not be available. FHR outside the range of normal 110-160 beats per minute is either prolonged or in decelerations. Fetal condition may also be assessed by measuring fetal blood gasses via a scalp sample. Fetal distress is more common with induced labors and may be the deciding factor for operative delivery (22). The process of uterine contractions leading to progressive effacement and dilation of the cervix and birth of the baby. A good labor pattern indicates successful induction or augmentation. A good labor pattern is described as three contractions in 10 minutes each lasting more than 40 seconds. The uterus should relax between contractions (21). Oxytocic dose should be maintained but not increased once this stage is achieved (18, 23). Alternative methods of cervical ripening and labor induction include: nipple stimulation to elicit natural oxytocin release in the pituitary to cause contractions, castor oil which works as a stimulant laxative to encourage descent of the fetal head by evacuation of the colon and may also stimulate uterine contractions(18, 19, 22, 23). Contractions more frequent than 3 in 10 minutes and/or lasting longer than 60 seconds in duration, with the uterus not relaxing between contractions. This protracted contraction of the myometrial muscle causes constriction of the vessels supplying blood to the uterus and to the placenta which can cause a separation of the placenta from the uterus (placental abruption), or a lack of oxygen to the fetus resulting in fetal compromise through asphyxia. Intrauterine pressure catheterization can be used to measure the pressure of the contraction for accurate diagnosis. Any oxytocin infused should be turned off immediately, and tocolytics considered in the case of hyperstimulation(23). 63
References 1. World Health Organization. World health report 2006. Geneva, Switzerland: WHO Press; 2006. 2. Disease control priorities project [homepage on the Internet]. [cited February 21, 2008]. Available from: http://www.dcp2.org/pubs/DCP/1/Table/1.2. 3. Post partum hemorrhage prevention.[homepage on the Internet]. . 2007. Available from: http://www.pphprevention.org/udd.php. 4. Weeks A, Alfirevic Z. Oral misoprostol administration for labor induction. Clin Obstet Gynecol. 2006 Sep;49(3):658-71. 5. Bartlett A, Paz De Bocaletti, ME. Intrapartum and neonatal mortality in a traditional indigenous community in rural guatemala. Act Paediatr Scand. 1991;80:286-8. 6. Aboyeji AP, Ijaiya M.-D.A. MA, Yahaya UR. Ruptured uterus: A study of 100 consecutive cases in ilorin, nigeria. Journal of Obstetrics and Gynaecology Research. 2001 [cited 21 December 2007];27(6):341-8. 7. Ahmed SM, Daffalla SE. Incidence of uterine rupture in a teaching hospital, sudan. Saudi Medical Journal. 2001 [cited 10 December 2007];22(9):757-61. 8. Al-Jufairi A, Sandhu A, Al-Durazi K. Risk factors of uterine rupture. Saudi Med J. 2001;22(8):702-4. 9. Ezechi O, Mabayoje P, Obiesie L. Ruptured uterus in south western nigeria: A reappraisal. Singapore Med J. 2004;45(3):113. 10. Sharan M, Strobino D, Ahmed S. Intrapartum oxytocin use for labor acceleration in rural india. International Journal of Gynecology and Obstetrics. 2005 [cited 10 December 2007];90(3):251-7. 11. Van Hollen C. Invoking vali: Painful technologies of modern birth in south india. Med Anthrop Q. 2003;17(1):49-77. 12. Khalil K, Elnoury A, Cherine M, Sholkamy H, Hassanein N, Mohsen L, et al. Hospital practice versus evidence-based obstetrics: Categorizing practices for normal birth in an egyptian teaching hospital. Birth (Berkeley, Calif.). 2005 [cited 29 February 2008];32(4):283-90. 13. Chigbu C, Ezeome I, Okenzie A, Oyefara B. Induction of labor on request in a resource-poor setting. Int J Gynaecol Obstet. 2007;98:208-11. 64
Page 1 and 2:
Use of oxytocin and misoprostol for
Page 3 and 4:
data from lower level and private f
Page 5 and 6:
the literature provides us with ver
Page 7 and 8:
Acronyms ACOG AMRN AMTSL CS EFM FDA
Page 9 and 10:
List of Tables Table 1.1a Published
Page 11 and 12:
1. Introduction Low and middle inco
Page 13 and 14: Comment Setting Country Source and
Page 15 and 16: 4) To summarize current rates, tren
Page 17 and 18: eview given its focus on the use of
Page 19 and 20: Category Inclusion Exclusion Ration
Page 21 and 22: Table 3.1a provides definitions for
Page 23 and 24: Prerequisite clinical conditions fo
Page 25 and 26: practitioner’s discretion as outl
Page 27 and 28: Table 3.3c WHO recommendations for
Page 29 and 30: Table 3.4a National induction rates
Page 31 and 32: variable induction rates in Washing
Page 33 and 34: Table 3.4c: The percent distributio
Page 35 and 36: studies that assessed this outcome.
Page 37 and 38: 3.5 Rates, Trends, Indications and
Page 39 and 40: Tables 3.5b presents rates of induc
Page 41 and 42: Table 3.5d Hospital-specific rates
Page 43 and 44: adverse outcomes of induction becau
Page 45 and 46: this is not associated with increas
Page 47 and 48: use in LRS, particularly given the
Page 49 and 50: Sweeping of the membranes was compa
Page 51 and 52: concern regarding its use for early
Page 53 and 54: Misoprostol is now available in som
Page 55 and 56: Figure 3.6 c World map showing glob
Page 57 and 58: documented rates of elective induct
Page 59 and 60: In general, definitions, descriptio
Page 61 and 62: An evidence-based safe and effectiv
Page 63: Appendix A: Glossary of common term
Page 67 and 68: 28. Beebe LA, Rayburn WF, Beaty CM,
Page 69 and 70: 55. Maternity statistics, england:
Page 71 and 72: 81. Roberts CL, Algert CS, Douglas
Page 73: 105. Nigam A, Singh VK, Dubay P, Pa
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?