Comments on: Standardizing Postpartum Oxytocin Administration

By: Steven Roth

Steven Roth — Sat, 20 May 2017 07:01:49 +0000

I am an OBGYN and had a private practice in the US for nearly 20 years. In the past 10 years I have worked in exclusively in New Zealand and Australia. When I first started in New Zealand I immediately noted that the PPH rate was astronomical compared to my US experience. I pointed this out to a midwife that asked if the 3rd stage was managed actively or physiologically. I didn’t know there was more than one way. Clearly physiologic management is associated with significantly more blood loss and yet the midwives here fight tooth and nail to continue this practice. Not only this issue, but it is routine that anesthesia gives undiluted boluses of oxytocin IV after delivery during c-section. Thank you for showing this significant reduction in PPH at your institution. It helps me battle to get rid of physiologic management and IV boluses. Maternal hemorrhage continues to be the number one cause of maternal death worldwide.

By: li2211

li2211 — Wed, 30 Nov 2016 03:15:12 +0000

PPH is one of those “worse case scenarios” for a nurse. Working directly with postpartum patients and unfortunately having experienced more postpartum hemorrhages than I’d like to count, I would like to see a thorough and specific universal protocol for these patients. I’d like to learn more about correlations between lengths of induction, length of labor and postpartum hemorrhaging. Also,for a patient who receives Pitocin after delivery, how is bonding with the newborn affected and is there anything we can do differently as nurses? (Now that we know that their own oxytocin- the one that helps with bonding, is trumped by the synthetic stuff). For the patients who hemorrhage after delivery, how does that extra bag of Pitocin affect bonding with their newborn, and in turn, does this decrease the likelihood of breastfeeding not only successfully, but exclusively? A standard protocol for Pitocin administration is very important to have and know. The more research about standard pitocin infusion there is, the better the service we can provide to our patients will be in order to enhance their postpartum experience and allow mom and newborn to be the protagonists, not a postpartum hemorrhage.

By: mrshowey

mrshowey — Thu, 15 Sep 2016 05:09:39 +0000

This is great. I am looking forward to reading this review. There is always something we can improve on and I’m hoping standardizing this high alert medication is one of them!

By: Shirley Scott

Shirley Scott — Fri, 05 Feb 2016 17:39:39 +0000

Interested to know if this protocol was used on all deliveries or just if they hemorrhaged?

By: Tina Hobbs

Tina Hobbs — Mon, 01 Feb 2016 13:53:12 +0000

I am in the process of PPH simulation and have recently written a clinical pathway for PPH, as well as an updated policy for management of PPH. I am extremely interested in this topic and am excited that someone is digging deeper into standardization of Pitocin in the 4th stage of labor. I have spoken to a few nurses on our unit about their clinical practice for Pitocin administration after delivery, and have had variable results, also. I think it is noteworthy that you have seen a decrease in PPH during the time of implementation of this change in your department. Thank you!

By: Kristan Clay

Kristan Clay — Wed, 27 Jan 2016 07:55:10 +0000

As nurses we are always looking out for what is best for the patient. By standardizing oxytocin given postpartum we can provide the best care to our patients.

By: Veronica Thomas

Veronica Thomas — Mon, 18 Jan 2016 00:19:55 +0000

this is the pp pit journal

By: Patti van Dalen

Patti van Dalen — Fri, 15 Jan 2016 06:22:35 +0000

Would be very interested in your study & results! I work ion OB and shred your information w/some co-workers. Be very interested in protocol & amounts pit used. Thank you!!

By: Alex Andreitchouk, MD, FACOG

Alex Andreitchouk, MD, FACOG — Sat, 09 Jan 2016 16:34:13 +0000

Decrease on PPH is directly related to dose/longevity of oxytocin infusion. There is no “magic”dose or hours. Many experts reccommeded longer infusion of oxytocin and results are better. Your protocol is just another variation in prophylactic administration of oxytocin. Personally I prefer lower dose and longer up to 12 hours infusion in higher risk patient. Combination of meds also could be very interesting and cost effective. Agree, studies are important in this area.

By: MOM

MOM — Sat, 09 Jan 2016 02:51:46 +0000

Very interesting and exceptional project. Definitely makes sense since there is such variation in Pitocin use post delivery. THanks for this valuable information, keep up the good work!