Notes for: Prostaglandins And OxytocicsLast edited [15/05/2012 11:25:23]
Prevention and treatment of haemorrhage:
Carboprost is only indicated for postpartum haemorrhage due to uterine atony in patients unresponsive to ergometrine and oxytocin.
Last edited [21/08/2013 14:41:24]
Induction and augmentation of labour:
Vaginal PGE2 is the preferred method of induction of labour, unless there are specific clinical reasons for not using it (in particular the risk of uterine hyperstimulation). The recommended regimens are:
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one cycle of vaginal PGE2 tablets or gel: one dose, followed by a second dose after 6 hours if labour is not established (up to a maximum of two doses)
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one cycle of vaginal PGE2 controlled release pessary: one dose over 24 hours.
See BNF and NICE Clinical Guidelines.
1. Misoprostol (unlicensed) is not currently used for routine Induction of Labour (IOL). It is however used for 2nd trimester Termination of Pregnancy (TOP) or Induction of Miscarriage. In selected cases it is used for IOL following Intra-Uterine Death (IUD/stillbirth). Misoprostol is used routinely prior to TOP in all nulliparous women and gestation of 12 weeks or more. It may be given orally or the tablet may be used vaginally.
2. Carbetocin is accepted for use only in caesarean sections.