cytotec question

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Hi I'm a new nurse in L&D and have a question for the experienced L&D nurses. What can you do if the patient is contracting too much after cytotec insertion? I had a patient that was contracting every minute but the doctor didn't want to stop the contractions with any tocolytics so what can I do? Will bolusing her with fluids help?

Specializes in L&D, QI, Public Health.
You didn't mention how long the Cytotec was in before the hyperstim began. Sometimes when first inserting Cytotec or Cervidil I have noticed and increase in contraction frequency which levels out after about an hour. If it has been longer than an hour since the Cytotec insertion and the ctx. are more than 5 in 10 minutes, I would do what everyone above suggests. If not, give her an hour and see what happens. Some of the new literature I have read on oxygen suggests that putting on an O2 mask should only be done at ten minute intervals - ten on then ten off - as it is no longer effective after ten minutes. IVF's have definitely showed to space out ctx. in early and preterm labor so maybe it would help. If not, as suggested above, go up the chain of command until something is done.

How does IVF space out ctx's (in general)?. What is the physiology behind it?

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