Oxytocin
Labor induction, Labor augmentation, Postpartum hemorrhage (uterine atony)
Indications
- Labor induction
- Labor augmentation
- Postpartum hemorrhage (uterine atony)
Adult dosing
- induction: dose: 0.5; maxDose: 40; unit: mU/min; route: IV; weightBased: false; titrationTarget: Titrate by 1-2 mU/min q30-60 min until adequate contractions (3 in 10 min); pph: dose: 10; unit: units; route: IM or 10-40 units in 1L LR IV; interval: Run at 200-500 mL/hr for PPH; fixed: true
Contraindications
- Prior classical uterine incision
- Active genital herpes with lesions
- Placenta previa/vasa previa
- Umbilical cord prolapse
- Transverse lie
Clinical pearls
- Half-life is short (~5 min) — steady state takes 40 min per dose change
- Max dose varies by institution: typically 20-40 mU/min
- Tachysystole (>5 contractions in 10 min): reduce or stop oxytocin, lateral positioning, IV fluid bolus
- For PPH: oxytocin is first-line uterotonic before escalating to methylergonovine, carboprost, or misoprostol
Source and review
- ACOG Practice Bulletin No. 107 (Induction), ACOG Practice Bulletin No. 183 (PPH). Last reviewed: 2024-11-01