Lack of training and storing facility for oxytocic agents, non-availability of trained birth attendants for administration of parenteral uterotonic
agents and non-availability of blood transfusion facility in rural areas further worsens the consequences of post-partum hemorrhage15.
10,11,12] Nausea and vomiting may be influenced by hormonal changes in pregnancy, which alter the sphincter tone of the oesophagus and the stomach and the activity of small bowel and oesophagus, as well as adverse effects of uterotonic
drugs, intraoperative manipulation of the uterus and psychological distress aggravated by insufficient anaesthesia.
Newer operational guidelines have been prepared and disseminated to the States for Screening for Diagnosis & management of Gestational Diabetes Mellitus, Hypothyroidism during pregnancy, Calcium supplementation during pregnancy and lactation, De-worming during pregnancy, Maternal Near Miss Review, Screening for Syphilis during pregnancy, Guidance note on use of Uterotonic
during labor and Guidance note on prevention and management of PPH.
When we are confronted with a patient with placenta previa experiencing massive haemorrhage during caesarean delivery, haemostasis is first attempted using uterotonic
drugs, uterine massage and intrauterine packing.
or oxytocic drugs are used to manage dysfunctional labour and new drugs for dysfunctional labour still remain largely unsearched.
13] It has been shown that uterotonic
activity of Ficus asperifolia extracts increased uterine contractility involving cholinergic (muscarinic) mechanism.
Active Is uterotonic
given within management of minute of birth, is the cord the third stage of clamped and is there labour controlled cord traction?
7) kit Availability of essential medicines for delivery Injectable uterotonic
The most common uterotonic
agent administered was syntocinon (95%), followed by prostaglandin F2a (59%) and misoprostol (56%).
7 Was the availability of uterotonic
agents confirmed (preferably oxytocin) for care during delivery?
Methergine is the only FDA-approved oral uterotonic
Uses of good uterotonic
agents and special surgical procedures such as step-wise devascularization and the B-Lynch technique have contributed to lowering the incidence of atonic PPH as the cause of obstetric hysterectomy.