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Oxytocin/Pitocin

Oxytocin is a naturally occurring substance in the human body associated with bonding as well as childbirth.  Pitocin is a synthetic oxytocin.  Much like oxytocin, Pitocin, is a uterine stimulant that causes contractions by changing calcium concentrations in the cells of the uterine muscles—however, Pitocin may cause significant harm to both mother and fetus.

Pitocin affects the mother differently from the naturally-occurring oxytocin that is produced by the body. Pitocin is more likely to cause artificially strong contractions than oxytocin, and is much more likely to cause adverse maternal or fetal outcomes. By administering Pitocin during an induction of labor or augmentation of labor, physicians must also be aware that the mother is also producing oxytocin naturally and adjust dosages accordingly.

Pitocin is not a dose-dependent drug, which means that each individual responds to the amount of Pitocin differently. This makes monitoring of Pitocin administration extremely important, as it can cause tachysystole (excessive uterine contractions) if too much is administered. Clinical studies have shown a correlation between use of Pitocin and adverse fetal outcomes.

Excessive Pitocin dosage or long-term usage over a 24 hour period has been associated with adverse maternal outcomes, including tachysystole, uterine rupture, postpartum hemorrhage, maternal stroke, and water intoxication. Some of these side effects can be fatal to a mother.

Pitocin is also associated with significant fetal injuries, including decreased heart rate or heart rate decelerations, decreased fetal blood pressure, increased intracranial pressure, cardiac arrhythmia, brain hemorrhage and brain damage, seizures, and death. Pitocin is especially dangerous when used in conjunction with other contraction augmentation agents, such as Cervidil (dinoprostone).  Pitocin can also complicate a vaginal birth after a caesarian section, as it increases the rate of uterine rupture.

Prolonged use of Pitocin may cause fetal injury by inducing excessive or lengthy contractions, which may occlude the flow of blood and oxygen to the baby from the placenta. Furthermore, it may also cause traumatic injury by compression of the baby’s head or impaction of the head on the maternal pelvis. These mechanisms can cause fetal stroke that may lead to permanent brain damage in a child.

The FDA issued a black-box warning—the FDA’s strongest warning—about the use of Pitocin in 2007. Label Seen Here. The FDA recommends that Pitocin should only be used when induction of labor is medically indicated or in select cases of stalled labor.

 

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