Emergency Uterotonics and Tocolytics

LWH

Emergency uterotonic and tocolytic doses used at Liverpool Women's Hospital.

Syntocinon (Oxytocin)

5 IU slow IV bolus +/- 5 IU

Then

40 IU IV infusion in 500 ml 0.9% NaCl at 125 ml/hr

Caution only

Tachycardia and hypotension if given quickly

Ergometrine

500 microgram IM

500 microgram IV, diluted in 10–20 ml 0.9% NaCl

Give with

Causes severe N&V — give with 50 mg IV cyclizine (slowly)

Contraindications

Severe hypertension, pre-eclampsia / eclampsia, cardiac disease

Syntometrine

1 ml amp (500 microgram; 5 IU) IM

Contraindications

As for ergometrine

Carboprost (Hemabate)

250 microgram IM every 10–15 min

Maximum

2 mg

Contraindications

Asthma, cardiac disease

Caution

Causes N&V

Misoprostol

1 mg PV or PR

Caution

Can cause pyrexia, N&V