Pitocin titration

[birdsnbees]

I've been a labor nurse for a long time now and worked in a few ob units, and up until now I've seen Pitocin run up to 20 mu/min, and occasionally with a doctors order, up to 25 mu/min. I've recently started working in a unit where they routinly titrate up to 50 and 60 and even higher during a routine induction of labor. I've looked on line trying to find safe titration levels but so far I have not found info in this. Has anyone ever run Pitocin at these doses?

[birdsnbees]

I wrote to ACOG and asked them about Pitocin titration and how much they recommend. They sent me a number of their bulletin's etc, and they don't give a high number recommendation. They do say that you are more likely to see side effects if you go above 40mu. They do talk about the high and low dosage which is as follows:

Low:

0.5-1 increase by 1 every 30-40 min

OR

1-2 increase by 2 every 15 min

High:

6 increase by 6 every 15 min

OR

6 increase by 6,3,1 every 20-40 min

*page 6 of ACOG Practice Bulletin #10, Nov 1999

[SmilingBluEyes]

I have found 8-10 mu is usually sufficient. That is usually the level it takes to somewhat equate physiological levels in spontaneously laboring women. Much more than that, you are courting PPH, water toxicity and other nasty problems. If you are unsure about your labor adequacy, use of IUPC is not a bad idea!