The Role of Pitocin in Labor and Delivery

Pitocin (oxytocin) is a hormone used to induce or strengthen labor contractions during childbirth, and can also be used to control postpartum bleeding. Misuse of Pitocin can have serious consequences for both mother and baby, such as oxygen deprivation and subsequent brain damage to the infant or uterine rupture for the mother.

How Pitocin Is Used

The hormone Pitocin is administered intravenously for the induction and augmentation of labor. If a mother is past her due date, the doctor may recommend Pitocin to induce labor. Doctors may also recommend the administration of Pitocin if labor is not progressing.

If a doctor decides that Pitocin should be used to induce or augment labor, the dosage should be 0.5–1 mU/min (equal to 3–6 mL of the dilute oxytocin solution per hour). At 30–60 minute intervals, the dose should be gradually increased in increments of 1–2 mU/min until the desired contraction pattern has been established[1].

Who Is Pitocin For?

Pitocin is not indicated for elective induction of labor, meaning the initiation of labor in a pregnant individual who has no medical indications for induction. Pitocin has antepartum and postpartum applications, including[2]:

  • Mothers who have medical indications for labor initiation, including Rh problems, diabetes, preeclampsia, if membranes prematurely rupture, or otherwise when vaginal delivery is in the mother’s and fetus’ best interests;
  • Mothers who need to have their labor stimulated or reinforced, for example, in some cases of uterine inertia;
  • Mothers who experience postpartum bleeding/hemorrhage. Doctors may also use Pitocin to produce contractions during the third stage of labor.

There are some exceptions to these uses. The use of Pitocin may be harmful in the following situations[3]:

  • Substantial cephalopelvic disproportion
  • Unfavorable fetal position or presentation
  • High-risk pregnancies where benefit-to-risk ratio favors surgical intervention
  • Cases of fetal distress in which delivery is not close
  • Uterine activity fails to reach sufficient progress
  • Uterus is hyperactive or hypertonic
  • Cervical carcinoma, total placenta previa, or other cases where vaginal delivery could be harmful
  • Patients who possess a hypersensitivity to oxytocin

Pitocin Overdosage

According to Pitocin’s drug label, overdosing on oxytocin depends on uterine hyperactivity.

“Hyperstimulation with strong (hypertonic) or prolonged (tetanic) contractions, or a resting tone of 15 to 20 mm H2O or more between contractions can lead to tumultuous labor, uterine rupture, cervical and vaginal lacerations, postpartum hemorrhage, uteroplacental hypoperfusion, and variable deceleration of fetal heart, fetal hypoxia, hypercapnia, perinatal hepatic necrosis or death.”

Adverse Reactions to Pitocin

Below are some of the adverse reactions to Pitocin (oxytocin) that have been reported[4]:

  • Postpartum hemorrhage (mother)
  • Cardiac arrhythmia (mother)
  • Fatal afibrinogenemia (mother)
  • Uterine rupture (mother)
  • Bradycardia (fetus)
  • Seizures (fetus)
  • Permanent CNS or brain damage (fetus)
  • Death (fetus)

Because of the risks associated with overdose and the potential for adverse reactions, any mother receiving Pitocin intravenously must be under constant observation by a professional trained specifically in oxytocin use – someone who is qualified to detect and manage complications that arise after Pitocin administration.

Study Suggests Oxytocin Use May Not Be As Safe As Once Thought

A study published in The American College of Obstetricians and Gynecologists found that oxytocin use may not be as safe as medical professionals once thought it was. Researchers found that oxytocin use was an independent risk factor for unexpected NICU admissions lasting longer than one day in full-term infants. Using oxytocin to augment labor was also linked to Apgar scores less than 7 at 5 minutes after birth. While the study did not conclude with a recommendation to cease use of Pitocin altogether, it did call for “a more systematic and conscientious approach” to how and when the hormone should be used[5].

Contacting Hampton & King

Hampton & King is a team of experienced birth injury lawyers in Houston. Allow our extensive experience in this field to help you identify if you might have a legal claim for compensation. If you believe that Pitocin administration caused injury to mother or child, we invite you to contact our law firm today for a free review of your legal rights and options.

Categories: Birth Injuries