Because, in 2001 the Royal College of Obstetricians and Gynaecologists 'advised' in a new policy document for induction of labour, that synthetic oxytocin should be used according to more concentrated dilutions than are licensed, and that - at the same time - the rates of infusion can be increased skipping over several possible licensed steps at once.
We believe these sharp increases may diminish the normal pattern of release of natural oxytocin, so that the optimum rate of infusion to enhance or promote as natural a labour as possible, may be missed - unnecessarily.
We (Monica Tolofari and Linn Shepherd) who have, in the past, used synthetic oxytocin according to the licensed directions, achieving an extremely low postpartum haemorrhage rate, want to flag up the aforementioned change to practice as well as that the postpartum haemorrhage rate (35% instead of 3-5%) is off any previous scale.
We were delighted to be invited to present our findings at the Midlands 2020 Maternity & Midwifery Online Festival. UK. See the Conference agenda - Click the link below https://www.maternityandmidwifery.co.uk/live-stream-midlands-maternity-midwifery-festival-2020/3583/#midlandslivestream
The use of electronic devices such as CTG, Sonicaid and Telemetry can malfunction because of interference from other sources maternal pulse, electrical/radio waves and is not 100% reliable, therefore use of a Pinard stethoscope for monitoring the fetal heart is absolutely necessary for the assessment of fetal well-being. providing the person listening has a fully functioning ear. When the Pinard is used, and documented in conjunction with electronic recorded devices, confirming the fetal heart by Pinard's is a great tool and skill for the clinical area
The Red Alert slide is for the benefit of doctors and midwives who work in countries where oxytocin (often for veterinary use) can be bought over the counter, and is allegedly being given by intramuscular injection to women in labour expecting a live baby, in home-birth settings. We warn against this to prevent changes to the maternal cardiac rhythm and hypoxia to the baby. Ideally, even after the baby has been born, Sytnometrine (containing 5 IU synthetic oxytocin and 500 micrograms ergometrine maleate) can be administered to aid separation of the placenta and controlled blood loss, rather than pure synthetic oxytocin 10 IU.
Syntometrine (containing 5 IU synthetic oxytocin and 500 micrograms ergometrine maleate) can be administered to aid separation of the placenta and controlled blood loss, rather than pure synthetic oxytocin 10 IU.
... because the licensed dosage range is available to be chosen instead, both for induction of labour and to improve the rhythm and strength of contractions which have already started.
It is unacceptable obstetric and midwifery prescribing practice to offer only unlicensed high doses of synthetic oxytocin (SO) without also giving a formal explanation of the changes, and giving the patient freedom to reject them, or give her formal, valid consent to the higher risks involved, such as greater pain requiring epidural analgesia to manage it.
Epidural drugs interfere with the physiology of labour, slowing labour down, and SO cannot be used safely to speed labour up again! The epidural immobilises a woman and stops her walking around and having an active birth.
High doses of SO, can lead to tetanic contractions, fetal distress, and interventions - higher Caesarian Section rates, forceps delivery, Post Partum haemorrhage (PPH), birth trauma, neonatal admissions and more. Epidural drugs also cross the placenta.
The only benefit is the possibility of a shorter labour – although the potential length of any one labour cannot be accurately guessed beforehand, so how long is shorter?
A stronger dilution is licensed for management of PPH if it happens, after the baby is born.
Synthetic oxytocin when used as directed (as licensed) leads to obstetric outcomes with as low an incidence of complication as spontaneous obstetric labour obtains.
This information is for women being offered an intravenous oxytocin induction
If you are expecting a baby - and induction of labour has been mentioned to you - you are welcome to use the charts from the Parliamentary petition download, (saved to a mobile device, or printed out), to show and discuss with your midwife and hospital doctors at your next meetings with them.
They may not have seen the full dosage range before - with all the possible steps between 1, 2, 4, 8, 12, 16 and 20 m/U per minute - but when they read the manufacturer's advice on p 4 of the petition download, they will see that these variations should be available as standard, for you to choose. Your fully informed consent is required before the infusion begins.
An epidural may not need to be recommended if you choose 5 IU in 500 ml or 2.5 IU in 500 ml (the licensed dilutions).
You can withdraw your consent at any time.during any procedure
Please note that all Parliamentary Petitions were closed early on the 6th November 2019 by the Parliamentary Committee, due to the UK Election scheduled for the 12th December 2019 https://petition.parliament.uk/petitions/277586
Syntocinon is a synthetic hormone called oxytocin, it is powerful enough to be bring forth a baby out of its mothers womb, it is licensed for medical use in Childbirth for Augmentation, Induction of labour and management of Post Partum Haemorrhage (PPH). It is especially useful for commencing, strengthening and restarting and enhancing uterine contractions when used as directed by the manufacturers licensed instruction. It has a long history of approximately 60 years use in hospitals across the world. Epidural analgesia may be needed with current oxytocin regimes in Western countries during the use of synthetic oxytocin infusion because of the strong uterine contractions that are produced by this synthetic hormone, If the therapeutic or licensed doses are used and smaller steps are titratied during administration according to manufacturer's licensed directions, women may not need epidurals enmasse when Induced or augmented (and the consequential intervention that comes with having an epidural) for pain relief.
How is synthetic oxytocin administered?
It is similar to the natural Oxytocin hormone found in the body and is delivered directly into the Bllod stream via a vein by drip infusion mixed with sterile electrolyte fluid infusion and the dosage is controlled by syringe driver, infusion by volumetric pump or manually by counting drops for drip infusion for accurate dosage according to the uterine contractions that have been Induced by synthetic oxytocin (drip infusion is used where access to volumetric pumps or syringe drivers are not available).
Natural Oxytocin is a very powerful nonapeptide hormone, synthesised in the hypothalamus and stored in the Pituitary gland in the brain, in readiness to be released directly into the blood stream when required, it acts in a pulsatile way. Oxytocin commonly known as the 'love' hormone. It is released when the body requires it for various reproductive and non reproductive functions such as non sexual touch, sexual function, olfactory stimuli and the commencement of uterine (womb) contractions in labour, during breastfeeding and after birth often causing uterine contractions called 'after pains'. During pregnancy there is a steady increase in oxytocin levels.
Syntocinon is man-made, used to stimulate rhythmic (womb) uterine contractions during labour augmentation and Induction of labour. After birth it is used to prevent and or control postpartum haemorrhage.
The Side effects are covered well on Net doctors click on link http://www.netdoctor.co.uk/medicines/pregnancy/a7608/syntocinon-oxytocin/
KHAJEHEL, M (2017). Labour and Beyond: The Roles of Synthetic and Endogenous Oxytocin in Transition to Motherhood British Journal of Midwifery, April 2017, pp230 - 238
Pregnant women who are informed of potential side effects, can be engaged in their care and be enabled to make informed decisions. The dose and dilution that a women and her unborn baby receives, can differ from one hospital to another. It is important for the safety and the management of labour and pain in the mother, that the current manufacturers's licensed Syntocinon dose and dilution is offered.
Contact us for further information
Examining and reviewing Syntocinon regimes across the UK. Answering mother's questions about Induction of labour
We would like a debate about the use of Synthetic oxytocin in labour and for the management of post partum haemorrhage. A parliamentary petition was launched by us in Ocyober 2019. There has been some delay due to the 1st Petition being rejected. The second petition was accepted at the end of October, only to be closed early a few days later on the 6.11.19 due to the pending UK Election on 12.12.19.
We will keep you updated
We are waiting for your reflections on your experience of induction of labour and testimonies
Syntocinon Partograms will be available to NHS Trusts & Private Sector Trusts
Mothers can contact us for information regarding Induction of Labour
Syntocinon a synthetic hormone called oxytocin , is a relatively mature medicine, used for sixty years for Induction of Labour. Please check the Syntocinon or synthetic oxytocin above for more details
1. What are my options and route for Induction? Natural and Alternative Complimentary medicine - Dietary methods, Aromatherapy, Acupressure/acupuncture and Herbal. Traditional hospital procedures and medicine - Membrane Sweep, Prostaglandins gel or pessaries, Syntocinon Infusion, Artificial rupture of membranes. 2. Can I refuse to be Induced? Answer Yes, but every decision taken does have consequences which can be positive or negative. Decide what risk is acceptable after gaining sound information, so that an informed decision can be made. 3. What is Syntocinon? Synthetic Oxytocin, a hormone similar to the natural hormone Oxytocin found in the body. See section above on Syntocinon. What are the side effects? See section on Syntocinon side effects
We are a group of midwives available to discuss your options for medical induction of labour
Based in the UK we are also available for professionals who need or want advice on updating their local Syntocinon (synthetic oxytocin) induction & augmentation guideline or policy
find us on facebook.com/oxytocinmeasures