Evatocin Special Precautions

All patients receiving intravenous Oxytocin must be under continuous observation by trained personnel who have thorough knowledge of the drug and are qualified to identify complications. A physician qualified to manage any complications should be immediately available.
When properly administered, Oxytocin should stimulate uterine contractions, comparable to those seen in normal labour. Overstimulation of the uterus by improper administration can be hazardous to both mother and fetus. Even with proper administration and adequate supervision, hypertonic contractions can occur in patients whose uteri are hypersensitive to Oxytocin. The physician, in exercising his judgment regarding patient selection must consider this fact.
Except in unusual circumstances, Oxytocin should not be administered in the following conditions; fetal distress, partial placenta previa, prematurity, borderline cephalopelvic disproportion and any condition in which there is a predisposition for uterine rupture such as major surgery on the cervix or uterus including caesarean section, over distention of uterus, grand multiparity or past history of uterine sepsis or of traumatic delivery. Because of the variability of the combinations of factors, which may be present in conditions listed above the definition of "unusual circumstances", must be left to the judgment of the physician. The decision must be made carefully by weighing the potential benefits, which Oxytocin can provide against the rare but definite potential for the drug to produce hyper tonicity or tetanic spasm.
Maternal deaths due to hypertensive episodes, subarachnoid hemorrhage, rupture of the uterus and fetal deaths due to various causes have been reported associated with the use of parenteral oxytocic drugs for induction of labour or for augmentation in the first and second stages of labour.
Oxytocin has been shown to have an intrinsic antidiuretic effect, acting to increase water reabsorption from the glomerular filtrate. Consideration should therefore be given to the possibility of water intoxication, particularly when Oxytocin is administered continuously by infusion and the patient is receiving fluids by mouth.
When Oxytocin is used for induction reinforcement of already existent labour, patients should be carefully selected. Pelvic inadequacy may be considered and maternal and fetal conditions should be evaluated before use of the drug.