Effectiveness of Pitocin in Established Labour Cases

 

Chauhan Prabha1*, Azad K.L.2, Bansal A.K.3, Mohan R. S.4, Shrivastava P.K.4, Chauhan V.K.S.4 and Tiwari Smita4

1Dept. of Obstetrics and Gynaecology, Govt. Medical College, Jagdalpur (Bastar) 494001

2Dept. of Pathology, Govt. Medical College, Jagdalpur (Bastar) 494001

3Professor and HOD, Dept. of Community Medicine, Govt. Medical College, Jagdalpur (Bastar) 494001

4Dept. of Community Medicine, Govt. Medical College, Jagdalpur (Bastar) 494001

ABSTRACT:

In this study 200 cases were included (100 cases were kept in study group to whom Pitocin drip was administered and another 100 cases in control group i. e. no drip was administered, natural course of labor was studied). 59% of cases in study group were administered 2.5 unit of Pitocin, 34% cases 5 unit while 6% cases 7.5units. Only 1% of cases needed 10 units of Pitocin.

 

KEYWORDS: Pitocin, study group, control group

 

INTRODUCTION:

The main drug used in the acceleration of labour was oxytocin which acts by establishing the uterine action. Many obstetricians have used oxytocin previously and have discussed its advantage and disadvantage along with its variables. Unpredictable and sometimes distorted results with intramuscular injections and no continues watch of the drug action on foetus producing alarming uterine spasms, an occasional rupture, therefore bad results were obtained. But now after the introduction of continuous intravenous oxytocin drip good results are being obtained.

 

Use of pitocin intravenously in the induction of labour and acceleration increased since 1950. It is used more frequently for induction of labour in the presence of certain medical and obstetrical indications. Pitocinin fusion soon after amniotomy has been widely advocated by Brad fort and garden 1968, Garud and Simmons (1968).

 

Since the first stage is shortened by syntocinon drip, patients do not require much assistance in the second stage of labour. Effective uterine contractions progress is maintained throughout the process of labour. In 1957 as per recommendation of the study group of World Health Organization (WHO) has expressed the view that in order to get a comprehensive picture of disease (any health problem) more and more studies should be carried out, Garg Narendra K. Hence this study was under taken to study the effect of pitocin drip in established labour cases.

 

MATERIALS AND METHODS:

In the present study (A) 100 cases were taken in the study group where pitocin drip was given to the mother 2.5 units of pitocin or syntocinon was mixed with 540 ml of 5 % gluco solution.

 

 

After proper antiseptic case drip was commenced at 20 drops/minute which was equivalent to 0.05 unit/minute dosage of pitocin required from 2.5 units to 10 units. (B) Control group 100 cases were included in this group no pitocin was given. Natural course of labour was studied. There a total of 200 cases were included in the present study, which was done in the year 1978-79 in Sultania Zanana hospital Bhopal (M.P.).

 

Detailed examination of each patient was carried out, beginning from the history of the cases regarding name, age, parity, history of period of amenorrhoea, last menstrual period, previous history regarding any operative interference during the processes of labor time of onset of labor pains, history of bleeding per vagina or leaking and any other complaint during the present pregnancy or past illness was interrogated.

 

Obstetric history was also recorded. Patient was examined symptomatically including routine general and physical examination and recorded. In study group any change in pulse, Blood pressure, temperature, dryness of mouth, and its duration was maintained after starting pitocin drip.

 

The first author was on bedside of the patient during the whole of the terms till the drip is running because in the words of Hellman (1957) “oxytocin is a dangerous drug and should surround by a aura of respect”.

 

OBSERVATIONS AND DISCUSSIONS:

The data thus collected were analyzed and interpretation was carried out. It is evident from table that 59 % of cases were delivered with minimum dose i.e. 2.5 units of pitocin 34 % cases were given 5 units for delivery Table-1 further shows that 6% and 1 % of the cases were given. 7.5 and 10 units of pitocin respectively for successful completion of the delivery. Intravenous infusion of dilute solution of oxytocin developed and reported by Theobald (1953) used for induction.

 

Table:- 1 Doses of Pitocin in unit administered

 

SR. No.

Dosage of Pitocin given

No. of cases

Percentage

1

2.5

59

59.00%

2

5.0

34

34.00%

3

7.5

06

06.00%

4

10.0

01

01.00%

Total

100

100.00%

 

 

Theobald (1948) et al used oxytocin drip effectively in concentration between 1:2,500 to 1:10,000. He reported that it was always safe to give pitocin drip in dilution not exceeding 1:5000.

 

Theobald (1956) et al used pitocin to accelerate labour. Theobald (1948) observed and stressed in his study that only physiological solution should be used 1:1000, while Nixon and Smyth (1959) used 1:200 and Dillon (1960) 1:125, Ryana (1960) observed 2.5 units mixed with 540 of Dextrose or Saline.

 

Oxitocin the dose of which is limited only by foetal distress cannot be used effectively unless three popular falcies are rejected, first that prolonged labor is often an expression of Cephalo Pelvic Disproportion (CPD), Secondly that uterus in primigravidac may rupture due to oxytocin and thirdly that there is a valid therapeutic destruction between hypotonic and hypertonic uterine contraction. Stimulation, properly supervised in safe to mother and child. It eliminates the problem of occipital to posterior position, results in a sharp decline in forceps delivery and reduces the need for massive analgesia during the processes of labour.

 

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Received on 10.04.2010

Accepted on 10.07.2010     

© A&V Publication all right reserved

Research J. Pharmacology and Pharmacodynamics. 2(6): Nov. –Dec. 2010, 376-377