bor, as in selected cases of uterine inertia; (3) as adjunctive therapy in the management of incomplete or inevitable abortion. in the first trimester, curettage is generally considered primary therapy. in second trimester abortion, oxytocin infusion will often be successful in emptying the uterus. other means of therapy, however, may be required in such cases. postpartum oxytocin is indicated to produce uterine contractions during the third stage of labor and to control postpartum bleeding or hemorrhage.

tions of factors which may be present in the conditions listed above, the definition of “unusual circumstances” must be left to the judgment of the physician. the decision can only be made by carefully weighing the potential benefits which oxytocin can provide in a given case against the rare occurrence of hypertonicity or tetanic spasm with this drug. maternal deaths due to hypertensive episodes, subarachnoid hemorrhage, rupture of the uterus, and fetal deaths and permanent cns or brain damage of the infant due to various causes have been reported to be associated with the use of parenteral oxytocic drugs for induction of labor or for augmentation in the first and second stages of labor. oxytocin has been shown to have an intrinsic antidiuretic effect, acting to increase water reabsorption from the glomerular filtrate. consideration should, therefore, be given to the possibility of water intoxication, particularly when oxytocin is administered continuously by infusion and the patient is receiving fluids by mouth. oxytocin should be considered for use only in patients who have been carefully selected. pelvic adequacy must be considered and maternal and fetal conditions thoroughly evaluated before use of the drug.

physiologic electrolyte solution should be used except under unusual circumstances. to prepare the usual solution for infusion, 1-ml oxytocin injection, 10 usp units/ml is combined aseptically with 1,000 ml of nonhydrating diluent (physiologic electrolyte solution). the combined solution, rotated in the infusion bottle to ensure thorough mixing, containing 10 mu/ml. add the container with dilute oxytocic solution to the system through use of a constant infusion pump or other such device, to control accurately the rate of infusion. the initial dose should be no more than 1 to 2 mu/min. the dose may be gradually increased in increments of no more than 1 to 2 mu/min. until a contraction pattern has been established which is similar to normal labor. the fetal heart rate, resting uterine tone, and the frequency, duration, and the force of contractions should be monitored. the oxytocin infusion should be discontinued immediately in the event of uterine hyperactivity or fetal distress. oxygen should be administered to the mother. the mother and the fetus must be evaluated by the responsible physician. b. control of postpartum uterine bleeding intravenous infusion (drip method): to control postpartum bleeding, 10 to 40 units of oxytocin may be added to 1,000 ml of a nonhydrating diluent (physiologic electrolyte solution) and run a rate necessary to control uterine atony. intramuscular administration: 1 ml (10 units) of oxytocin can be given after the delivery of the placenta. c. treatment of incomplete or inevitable abortion intravenous infusion with physiologic saline solution, 500 ml, or 5% dextrose in physiologic saline solution to which 10 units of oxytocin have been added should be infused at a rate of 20 to 40 drops per minutes.

dice neonatal retinal hemorrhage

plasma half-life of about 3 to 5 minutes. following parenteral administration, uterine response occurs within 3 to 5 minutes and persists for 2 to 3 hours. its rapid removal from plasma is accomplished largely by the kidney and the liver. only small amounts oxytocin are excreted in the urine unchanged.