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Contraindications
Cephalopelvic disproportion; abnormal presentation of the foetus; hydraminios; multiparae; previous caesarian section or other uterine surgery; hyperactive or hypertonic uterus, uterine rupture; contraindicated vaginal delivery (invasive cervical cancer, active genital herpes, prolapse of the cord, cord presentation, total placenta previa or vasa previa); foetal distress where delivery is not imminent; severe pre-eclamptic toxaemia.
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Special Precautions
CV disorders; >35 yr; lactation. Monitor foetal and maternal heart rate, maternal BP and uterine motility. Monitor fluid intake and output during treatment. Discontinute immediately if the uterus is hypertonic or hyperactive or if there is foetal distress. Use of nasal spray may produce maternal dependence on its effects. IM admin not regularly used due to unpredictable effects of oxytocin. Not to be used for prolonged periods in resistant uterine inertia, severe pre-eclampsia, or severe CV disorders. Risk of water intoxication when used at high doses for prolonged periods.
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Adverse Reactions
Foetus or neonate: Jaundice; arrhythmias, bradycardia; brain, CNS damage; seizure; retinal haemorrhage; low Apgar score. Mother: transient hypotension, reflex tachycardia; nasal irritation, rhinorrhoea, lachrymation (following nasal admin); uterine bleeding, violent contractions, hypertonicity; spasm; nausea, vomiting.
Potentially Fatal: Maternal water intoxication (especially with slow infusion over 24 hr); prolonged uterine contractions causing foetal hypoxia and death; rupture of gravid uterus; afibrinogenaemia; subarachnoid haemorrhage |
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Drug Interactions
Possible severe hypertension if given within 3-4 hr of vasoconstrictor in association with a caudal block anaesthesia. Cyclopropane anaesthesia may increase risk of hypotension and maternal sinus bradycardia with abnormal AV rhythms. Dinoprostone and misoprostol may increase uterotonic effect of oxytocin, thus oxytocin should not be used within 6 hr after admin of vaginal prostaglandins. Concurrent use may increase the vasopressor effect of sympathomimetics.
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ATC Classification
H01BB02 - oxytocin ; Belongs to the class of oxytocin and analogues. Used in posterior pituitary lobe hormone preparations.
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