Do you turn off Pit when adequate labor is established??

[Bridget41040]

Hi everyone! I'm a new L&D nurse and taking my intermediate fetal monitoring class and I'm learning so much. I learned a few things about pitocin that I'd never heard before, or even seen practiced.

#1 90% of women will go into active labor on 6mu/min or less of Pit.

#2 Once active labor is established, most women will continue labor on their own and pitocin can be discontinued.

This is straight from the AWHONN material. I have never seen this done. They say the less pit the better for maternal-fetal status but most OB's I know love to up the pit and keep it there.

So my question is, do you ever turn off the pit during adequate labor? This is probably something you would need MD approval of correct? Or is assumed that you turn off pit during adequate labor? Please share your input.

[NurseNora, BSN, RN]

The half life of Pit is 10-15 min and it takes 3 half lives to reach a steady state blood concentration. That's why the AWHONN recommendation is to not increase more often than q30min. When we increase q15, it's not uncommon to blow right past the effective dose because we didn't allow time for it to reach a steady concentration. Then we had too many contractions and a dysfunctional labor pattern. I see women delivering with much lower doses than I used to see when I was a young nurse.if I get my Pit up past 12mU/min, I know we're going to have problems.

I've met very few docs who are willing to turn the Pit off once she's 8 cm, so I haven't really had much opportunity to see that it really works. It's all I can do to talk them out of starting it when she's 10 cm and her contractions slow down a little!

[eden]

Sometimes we turn it off but more often then not we either keep it at a steady rate without increasing it once good labour patterns are established or we half it to see if labour keeps going on it's own.

[mommy2boysaz]

It is typical to just leave it at it's "therapeutic" level once you reach that point, but I have seen it turned off once active labor kicks in and it does not hinder labor.

[Katie71275]

I usually leave it going with ctx q 2-3mins as long as baby is tolerating.

[►that_funky♪&#]

This is one reason I am so scared of going into OB, administering Pitocin! One little mistake is all it takes to have something horrible go wrong. How scary was it your first few times as a new OB nurse administering pit? For those of you that also had this fear of administering medications, how did you get over your fear? OB is really my only interest....

[DFRAZIER25]

Once ctx. are adequate I don't touch the Pitocin!! Leave it be. Sometimes you will see if you turn it off or down your ctx. go away all together or they become irregular and not strong enough.