Medications Affecting Labor and Delivery
Defining characteristics:
Used to bring about or increase labor or used to manage preterm labor
Oxytocin: uterine stimulant
Increase the force, regularity, and endurance of uterine contractions.
Therapeutic for overdue deliveries, PROM, preeclampsia, improving dysfunctional labor, delivering
placenta, achieving postpartum bleeding,
Pre-assess high risk factors, assess contractions and characteristics, assess fetal status, Assess VS, Assess
I&)
Complications: Water intoxication, Uterine tachysystole, severe HTN
Contraindications: Maternal-sepsis, unripe cervix, genital herpes, hx of uterine surgery
Fetal-immature lungs, cephalopelvic disproportion, malpresentation, prolapsed umbilical cord, fetal
distress, impending spontaneous abortion
Nursing considerations:
Use IV pump. Titrate dose no more than 6 milliunits every 40 minutes. Assess VS every30-60 minutes
and with every dose change. Contractions should be every 2-3 minutes and last 45-60 seconds each.
Assess for uterine tachysystole.
Continuous monitoring FHT for rate and rhythm.
Tocolytics: uterine relaxation
Hydroxyprogesterone caproate prevents pre-term labor.
Therapeutic uses,
Nifedipine
May be used as maintenance dose to suppress pre-term labor
SEs include hypotension, headache, dizziness, nausea
Contraindications: hypersensitivity. Use cautiously with hypotension, hepatic or renal disease, acute MI.
Avoid use with magnesium sulfate. (skeletal muscle blockade)
Interactions: increase effects of digoxin, phenytoin, beta blockers, antihypertensives. Avoid the use of
grapefruit juice St John’s wart, ranitidine, cimetidine grape related to increased effect of nifedipine.
Magnesium Sulfate: CNS depressant and relaxes smooth muscle. Prevents seizures in preeclampsia
Maternal SEs-hypocalcemia, dyspnea, hot flashes, transient hypotension,
Intolerable SEs- RR < 12/min, altered mental status, pulmonary edema, severe hypotension, urine output
< 25mL/hr, serum magnesium > or = 10mEq
Fetal-reduced fetal heart rate variability, nonreactive NST
Nursing actions: Assess DTR, VS, serum magnesium, limit IV fluids to 125/hr, have calcium gluconate on
hand. Assess toxicity. Limit fluid intake to 2500-300mL/day. Assess glucose for with DM.
Increases the effects of digoxin.
Glucocorticoid medications: Produce and release surfactant which stimulates fetal lung maturity. Reduce
fetal respiratory distress syndrome, intraventricular, necrotizing enterocolitis and death.
Complications: decreased fetal breathing and movements
Administer deep IM for clients who are 24-34 weeks gestation at least 24 hours prior to but no more
than 7 days prior to delivery.
Administer betamethasone12mg Im for 2 doses 24 hours apart; 6mg IM for 4 doses 12 hours apart
