The use of uterotonic drugs during caesarean section.
The administration of oxytocic drugs during caesarean section is an important intervention to prevent uterine atony or treat established postpartum haemorrhage. Considerable past and current research has shown that these agents have a narrow therapeutic range. A detailed knowledge by anaesthetists of optimal doses and side effects is therefore required. Oxytocin remains the first line agent. In view of receptor desensitisation, second line agents may be required, namely ergot alkaloids and prostaglandins. This review examines the adverse haemodynamic and side effects, and methods for their limitation. An approach to dosing and choices of agent for the limitation of postpartum haemorrhage is suggested.
Dyer
R A
RA
Department of Anaesthesia, University of Cape Town, South Africa. robert.dyer@uct.ac.za
van Dyk
D
D
Dresner
A
A
D000328:Adult; D002585:Cesarean Section; D004874:Ergonovine / Q000627:therapeutic use; D004876:Ergot Alkaloids / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000031:analogs & derivatives / Q000627:therapeutic use; D020250:Postoperative Nausea and Vomiting / Q000628:therapy; D011247:Pregnancy; D011453:Prostaglandins / Q000627:therapeutic use; D014591:Uterine Diseases / Q000188:drug therapy; D014593:Uterine Inertia / Q000188:drug therapy
D004876:Ergot Alkaloids; D010120:Oxytocics; D011453:Prostaglandins; C038346:syntometrine; D010121:Oxytocin; C020731:carbetocin; D004874:Ergonovine