Oxytocin Shortage: Recommended Alternative Strategies
Oxytocin is a frequently used medication on labor and delivery units. While there are other drugs that can be used for various procedures, oxytocin remains central to obstetric practice. Currently, there is a national shortage of oxytocin. ACOG recommends alternative strategies with an understanding that multi-disciplinary teams will be required to implement alternatives until the shortage is resolved.
Recommended Strategies to Consider
Review and develop a hierarchy for scheduled and unscheduled inductions
PPH risk analysis
Consider specific indications and contraindications to uterotonics
Admission criteria for active labor
Example: Consider cervical dilation ≥4 cm
Other cervical ripening agents for IOL
Example: Balloon with misoprostol vs concomitant oxytocin
Active management of labor
Enhance induction with nonpharmacologic interventions, e.g., amniotomy
Plan ahead with updated individual risk stratification
Stratify and update individual risk for postpartum hemorrhage
Retain the intrapartum infusion bag for the same patient in case of hemorrhage in the postpartum period
Oxytocin 10 U IM
Alternative uterotonics depending on patient risk factors (one-time dosing)
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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