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Low dose pitocinFrom: CNMPAT@aol.comThu Jul 18 08:33:29 1996
Appreciate your information about low dose pitocin. Actually, I think I got the original protocol from Nancy Davidson, in Spokane, but some OBs I've worked with were familiar with it too. We use it too, sometimes, and usually with good results. Works best with someone having contractions, but needing to become more ripe, usually with ROM. I do not like to give Seconal for any reasons, for I understood it stayed with the baby for several days following birth, and the mom would potentially be quite groggy. I prefer po Vistaril (100mg), which usually promotes sleep without the hangover effect. We use prostin for someone without contractions, but more concerned about hyperstim when women are having contractions. I do everything I can to promote sleep for the mom, so try to minimize nurse involvement and vital signs. Once I know the mom and baby are fine with the low level of pitocin, I ask the nurses leave them alone. The mom will usually call or be up if the contractions become more uncomfortable. The new cervical ripening preparations also do a good job of preparing the cervix. Any other comments about low dose pitocin?? << We've used low-dose Pitocin for cervical ripening for probably 5-6 years with varying degrees of success, we have a protocol at all of the hospitals here that spells out procedure, essentially the mom is admitted in the evening, has a baseline efm strip run, has an IV started and pitocin is begun at 1mu/min and slowly advanced until mild/moderate uc's are occuring q 3-4 min, monitors are usually left in place if the mom doesn't mind(I usually write orders to take them off after 2 hours) she is offered Seconal 100mg po for sleep(may repeat x 1 if not asleep in 1 hour) and has vitals and fht's (if not monitored) q 2hours while awake, if asleep is left alone, with an unripe cervix(low Bishops score) the cervix usually softens and begins to open, usually at 6am an exam is done and the pit is changed to the normal dosing regimen increasing it q 15-30 min by 1-2mu/min until uc's are q 2-3 min.With the advent of cervidil we choose one over the other dependent upon the bishps score and maternal preference. According to our policies one on one nursing is not needed until active management begins.Let me know if you have any questions. All my best, Joseph>>> Pat Sonnenstuhl, CNM,ARNP,RH South Sound Women's Center: 2 CNMs and 3 OB/GYNs Olympia, WA (1-800-633-1877) cnmpat@aol.com HTTP://home.aol.com/CNMPAT July 18, 1996 6:26 am
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