Typical rate/dosage pitocin after C-Section

Specialties Ob/Gyn

Published

We have a new surgeon who is new to doing C-Sections and his Pit order is drastically different from our other surgeon, just wondering if it is a typical rate and dosage. This is not a typo:

80 units of Pitocin in 500 cc Normal Saline to run at 17 cc/MINUTE, run in the whole bag. This is to be started after cord is clamped.

Safe? Normal? I dont usualy work OB...

Jessica

Specializes in Inpatient OB.

Our perinatologist has instituted a new pp pit protocal over the the last year or so. 40 units of pitocin in 500 cc D5LR to run in wide open after a c-section. 30 units in 500 cc D5LR over 30 minutes for SVD. It seems we have seen an increase in our use of misoprostil, hemabate, methergine for PPH. One article I read implied it was not the overall dosage of the pitocin but the length of time it is infused that helps control the bleeding. I have not done an official evidence based lit search but we really have increased our bleeding, I believe by running in more over less time. We'll see.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

We had one doc who did 40 units in a liter. SHe also didn't have any post-C/S toradol orders. Those pts were ALWAYS complaining of uterine pain.

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Specializes in Ante-Intra-Postpartum, Post Gyne.

We only use 20units added to the first bag of 1000ml of LR or D5LR. The rate is usually 150 but can depend on how much bleeding. At a previous hospital they used 40 units for post-partum, but they used a lot more pit during labor.

We will run it "wide open" is the woman is hemorrhaging after a lady partsl birth, but I have never heard of 80 units of pit in 500ml!

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I went to an OB ICU conference in Scottsdale, AZ and there was a presentation by Karrie Francois, MD on PPH. She stated that up to 80U can be administered PP even if PPH is not an issue. On PP C/S pt's in our facility may get up to 40units just in the amount of time it takes to close after the cord is cut. Then we give at least another 20 in PACU.

I do have a few questions:

1) After the intial 80units post-op, do they get additional Pitocin?

2) Do your sections get Duramorph in their spinals for post op pain control? That would take care of the "Ouch" issue...a thought

3) Did you ask the MD his rationale behind the dosage ordered?

4) Did you administer it as ordered without question? If so, why?

We do not have an MD who utilizes Pit the way this MD does, but they all have their quirks! I am really interested to know what his rationale is...I am doing a PPH project right now...

Shannon

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Specializes in Anesthesia.

20-40U of Pitocin seems to be the most common at the hospitals where I have done C-sections.

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