What is the dosage of Oxytocin (Pitocin) after birth?

From the Guidelines

Pitocin should be administered as a slow i.v. infusion of 2 U/min after placental delivery to prevent maternal hemorrhage. This dosage is based on the most recent and highest quality study available, which prioritizes minimizing the risk of systemic hypotension and promoting effective uterine contraction to reduce the risk of postpartum hemorrhage 1. The use of pitocin in this context is crucial for preventing maternal hemorrhage, and the specified dosage is designed to achieve this goal while minimizing potential side effects. Some key points to consider when administering pitocin include:

• The importance of avoiding systemic hypotension, which can be achieved through slow i.v. infusion
• The potential usefulness of prostaglandin F analogues in treating postpartum hemorrhage, unless an increase in pulmonary artery pressure is undesirable
• The contraindication of methylergonovine due to the risk of vasoconstriction and hypertension
• The need for meticulous leg care, elastic support stockings, and early ambulation to reduce the risk of thrombo-embolism, as highlighted in the study by the European Society of Cardiology 1. It is essential to monitor the patient's response to pitocin and adjust the dosage as needed to ensure effective uterine contraction and minimize the risk of complications.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION ... Control of Postpartum Uterine Bleeding Intravenous Infusion (Drip Method) – To control postpartum bleeding, 10 to 40 units of oxytocin may be added to 1,000 mL of a nonhydrating diluent and run at a rate necessary to control uterine atony

Intramuscular Administration – 1 mL (10 units) of oxytocin can be given after delivery of the placenta.

The dosage for oxytocin (Pitocin) after birth to control postpartum uterine bleeding is:

• Intravenous Infusion: 10 to 40 units of oxytocin added to 1,000 mL of a nonhydrating diluent, at a rate necessary to control uterine atony.
• Intramuscular Administration: 1 mL (10 units) of oxytocin after delivery of the placenta 2.

From the Research

Dosage for Pitocin after Birth

• The dosage for Pitocin (oxytocin) after birth is not explicitly stated in the provided studies, but the studies discuss the use of oxytocin as a first-line uterotonic agent for preventing postpartum hemorrhage 3, 4, 5.
• A study comparing carboprost and oxytocin for active management of the third stage of labor used an intramuscular dose of 10 units of oxytocin 4.
• Another study discussing second-line uterotonics and the risk of hemorrhage-related morbidity does not specify the dosage of oxytocin used 6.
• A review of uterotonic medications mentions oxytocin as the first-line agent but does not provide specific dosage information 5.
• A randomized controlled trial evaluating second-line uterotonics for uterine atony does not focus on oxytocin dosage but rather compares methylergonovine and carboprost as second-line agents 7.

Uterotonic Agents and Postpartum Hemorrhage Prevention

• The use of combined therapy rather than oxytocin alone is recommended for preventing postpartum hemorrhage 3.
• Carboprost has been shown to be a effective alternative to oxytocin in some cases, with a significant reduction in duration of third stage of labor and blood loss 4.
• Methylergonovine may be a more effective second-line uterotonic compared to carboprost in reducing the risk of hemorrhage-related morbidity 6.
• Oxytocin, methylergonovine, carboprost, and misoprostol are commonly used to restore uterine tone and prevent postpartum hemorrhage 5.