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Oxytocin
initiates contractions or enhances ineffective contractions (labor
augmentation). LR 1000ml with 10 units Pitocin infused at rate of 6 mL/hr; rate can be
changed, based on protocol and careful assessment of contractions. Goal:
contractions q 2 -3 mins, lasting 40 – 60 secs. Risks: hyperstimulation →
hypertonic contractions with inc resting tone, ↓ placental perfusion,
fetal distress, uterine rupture, H20 intoxication.
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Prostaglandin E2
– gel or tablets for cervical ripening (softening & effacing the
cervix); Prepidil and Cervidil; vaginal birth within 24 hrs avg.
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Misoprostol: (Cytotec) synthetic prostaglandin E1
analogue in tablet form. Contraindicated in maternal asthma, Hx of uterine
scar or bleeding; non-reassuring FHR tracing.
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Amniotomy –
artificial ROM, most common operative procedure in OB. Amnihook inserted
through cervix that is dilated to
atleast 2 cm. May induce or augment labor or to insert a fetal internal
monitor.
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Nursing
management: observe FHR just before & after amniotomy & compare.
Marked changes: cord prolapse. Assess fluid for amount, color, odor, presence
of meconium. Cleanse perineum & change underpads.
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Refer to Drug
guide, p 430 – 431.
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Refer to
Clinical Pathways: fFor Induction of Labor pp 432 – 433.
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