Is Oxytocin Contraindicated in Asthma?
No, oxytocin is not contraindicated in asthma and is actually the preferred uterotonic agent for pregnant women with asthma during labor and delivery. 1
Oxytocin as the Preferred Choice in Asthma
Oxytocin is specifically recommended as the uterotonic of choice for women with respiratory diseases, including asthma, during the active management of the third stage of labor. 1
The European Respiratory Society explicitly identifies oxytocin as safe for use in women with asthma, in contrast to other uterotonic agents that should be avoided. 1
Uterotonics That ARE Contraindicated in Asthma
Ergometrine is absolutely contraindicated in women with asthma because it may cause bronchospasm. 1
Prostaglandin F2α, used to treat postpartum hemorrhage, may cause bronchoconstriction and is not recommended in women with asthma. 1
Clinical Context: Continuing Asthma Medications During Labor
All usual respiratory medications, including bronchodilators and inhaled corticosteroids, should be continued during childbirth without interruption. 2
It is safer for pregnant women with asthma to be treated with appropriate medications than to have uncontrolled symptoms that compromise maternal and fetal oxygenation. 2, 3
Uncontrolled asthma during pregnancy increases risks of perinatal mortality, preeclampsia, preterm birth, and low birth weight—risks that substantially exceed any medication-related concerns. 2
Practical Administration Guidelines
Administer oxytocin 5-10 IU via slow IV or intramuscular injection at the time of shoulder release or immediately postpartum for active management of the third stage of labor. 1
Careful titration is essential to avoid uterine hyperstimulation, but this precaution applies to all patients, not specifically those with asthma. 1
Common Pitfall to Avoid
Never withhold or reduce necessary asthma medications (bronchodilators or inhaled corticosteroids) during labor due to pregnancy or delivery concerns, as uncontrolled respiratory disease poses substantially greater risks to both mother and fetus than the medications themselves. 2
Do not substitute ergometrine or prostaglandin F2α for oxytocin in asthmatic patients, as these agents carry specific bronchospasm risks. 1