Post partum drugs in cardiac patients

Question 1

Need for syntocinon augmentation in labour

Answer 1

Use double-strength syntocinon but halve rate to reduce total volume of fluids given

Question 2

Syntocinon as prophylaxis against postpartum haemorrhage

Answer 2

• Low-dose infusion (12 mU/minute): use either 5 i.u. in 50 ml at 7 ml per hour or 10 i.u. in 500 ml at 36 ml per hour
• Continue for 4 hours (longer if concerns)

Question 3

Postpartum haemorrhage

Answer 3

• For uterotonic, misoprostol 600 micrograms rectally is
  preferred, but monitor for hyperpyrexia
• Avoid hemabate or high-dose syntocinon
• Consider use of compression suture
• Consider the use of baloon
• Consider central access or arterial monitoring