Oxytocin

In the first trimester of pregnancy, oxytocin is used only for spontaneous or induced abortions. Numerous data on the use of oxytocin, its chemical structure and pharmacological properties indicate that, subject to the instructions for use, oxytocin does not affect the formation of fetal malformations.
In small amounts, penetrates into breast milk.
When using the drug to stop uterine bleeding, breastfeeding can be started only upon completion of the course of treatment with oxytocin.

Before embarking on the use of oxytocin, the expected beneficial effect of therapy should be compared with the possibility, although rare, of the development of hypertension and tetany of the uterus.
Until the insertion of the fetal head into the pelvic inlet, oxytocin cannot be used to stimulate labor.
Each patient receiving intravenous oxytocin should be kept in the hospital under the constant supervision of experienced professionals who are familiar with the drug and are recognized as qualified in recognizing complications. Immediate medical assistance should be provided, if necessary. During the use of the drug should be constantly monitor uterine contractions, cardiac activity of the woman and the fetus, the blood pressure of the woman in order to avoid complications. If there are signs of hyperactivity of the uterus, oxytocin should be stopped immediately; as a result, the uterine contractions caused by the drug usually subside soon.
With adequate use, oxytocin causes uterine contractions similar to spontaneous labor. Excessive stimulation of the uterus in the event of improper use of the drug is dangerous for both the parturient and the fetus. Even with adequate use of the drug and appropriate observation, hypertensive contractions of the uterus occur when the uterus is sensitive to oxytocin.
Should be considered with the risk of developing afibrinogenemia and increased blood loss.
There are cases of the death of a woman in labor as a result of hypersensitivity reactions, subarachnoid hemorrhage, rupture of the uterus and fetal death for various reasons related to parenteral administration of the drug for induction of labor and stimulation in the first and second periods of labor.
As a result of the antidiuretic effect of oxytocin, the development of overhydration is possible, especially with the use of a constant infusion of oxytocin and the ingestion of fluid.
The drug can be diluted in solutions of sodium lactate, sodium chlorate and glucose. The finished solution should be used in the first 8 hours after preparation. Compatibility studies were performed with 500 ml infusions.

Symptoms: depend mainly on the degree of hyperactivity of the uterus, regardless of the presence of hypersensitivity to the drug. Hyperstimulation with hypertonic and tetanic contractions or with a base tone of ≥15-20 mm aq. Art. between two contractions leads to erratic labor, rupture of the body or cervix, vagina, bleeding in the postpartum period, uteroplacental insufficiency, fetal bradycardia, hypoxia, hypercapnia, compression, birth trauma or death. Hyperhydration with convulsions as a result of the antidiuretic effect of oxytocin is a serious complication and develops with prolonged administration of large doses (40-50 ml / min).

Treatment of overhydration: elimination of oxytocin, limiting fluid intake, using diuretics to force diuresis, intravenous administration of hypertonic saline, correcting electrolyte imbalance, relieving seizures with appropriate doses of barbiturates and providing professional care for a patient in a coma state.