Uterotonic drugs and devices
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Photo: Sridharan Rangachari |
Oxytocics (such as oxytocin and ergometrine) and prostaglandins have strong uterotonic properties and have long been used to treat uterine atony and reduce the amount of blood lost during childbirth and placental delivery. They have also been widely used in obstetric and gynecological practice for cervical ripening and induction of labor.1 Use of a uterotonic drug immediately after the delivery of the newborn is one of the most important interventions used to prevent PPH.
Oxytocin |
Ergometrine |
Misoprostol |
|
|---|---|---|---|
Efficacy |
Drug of choice Highly effective |
Effective |
Less effective than oxytocin |
Response time |
Acts in 2–3 minutes |
Acts in 6–7 minutes |
Time to attain peak concentration 13–42 minutes |
Costs |
US$0.10 to 0.21 per dose (10 IU plus syringe) (US$0.40–0.60 Uniject™ device) |
Inexpensive—similar to oxytocin |
US$.40–3.00 per dose |
Route of administration |
Injection (syringe or Uniject™ device) |
Injection (oral less effective and unstable) |
Oral (3 x 200 μg pills or 600 μg ) |
Side effects |
Minimal |
Nausea and vomiting possible |
Shivering and elevated temperature common |
Storage |
2–8° C, 3 months at room temperature (30 ° C) |
Cold storage Light sensitive |
Room temperature Sensitive to humidity |
Uniject is a trademark of BD
1 Gülmezoglu AM, Forna F, Villar J, Hofmeyr GH. Prostaglandins for prevention of postpartum haemorrhage (Cochrane Review). The Cochrane Library. 2004;3:1–99.