Antidote: Calcium Gluconate or Calcium Chloride: Excessively Frequent Uterine Contractions During Pregnancy

ATI Maternal Medications
Nifedipine – CCB, suppress contractions by inhibiting calcium from entering smooth m.
- Monitor for headache, flush, dizziness, nausea

- Do not administer if pt receiving magnesium sulfate or following beta-adrenergic agonist
- Slow position changes, increase hydration
- Used for:
o Preterm labor
o Gestational hypertension
Magnesium Sulfate – tocolytic (suppress premature labor) CNS depressant, relaxes smooth muscle, inhibits uterine activity by
suppressing contractions
- Used for:
o Preterm labor
o Anticonvulsant for pts who have eclampsia and severe preeclampsia
- Contraindication: active vaginal bleeding, dilation of cervix greater than 6cm, chorioamnionitis, greater than 34 wks
gestation, acute fetal distress
- Do not give with Nifedipine or to pts with myasthenia gravis
- D/C: if pt exhibits: pulmonary edema (chest pain, SOB, resp. distress, wheezing/crackling, productive cough)
- Adverse effects: hot flash, sweating, burning at iv site, non reactive nonstress test, reduce fetal HR
- Magnesium Sulfate toxicity:
o absence of patellar Deep tendon reflex
o Urine output less than 30mL/hr
o RR less than 12/min
o Decrease level of consciousness
o Cardiac dys
- Antidote: Calcium Gluconate or calcium chloride
Terbutaline- beta-adrenergic agonist, tocolytic, relaxes smooth mus, inhibit uterine activity
- Assess hx of cardiac disease, pregestational or gestational diabetes, preeclampsia w/ eclampsia, gest. Hypertension,
hemorrhage. – do not take terbutaline
- Monitor: chest discomfort, palpitation, tachycardia, tremors, vomiting, hypoK, hypergly, hypotension
- Notify if HR greater than 130, chest pain, MI, BP 90/60
- Administer 0.25mg SQ q4, for 24hrs
- Used for:
o Preterm labor
o Inversion of uterus- Relaxes the uterus prior to the provider’s attempt to at replacement of the uterus into the
uterine cavity and uterus reposition
▪ Maintain stabilization of hemodynamic status
▪ Avoid aggressive fundal massage
▪ Administer Oxytocic as prescribed & broad spectrum antibiotics
o Tachysystole- excessively frequent uterine contractions during pregnancy.
Indomethacin- NSAID, suppress preterm labor by blocking production of prostaglandin. Inhibits uterine contractions
- Can cause premature narrowing or closure of ductus arteriosus in the fetus

- D/C: pulmonary edema, respiratory distress, productive cough, blood tinged sputum
- Do not exceed 48hrs
- ONLY used if less than 32 weeks
- Monitor postpart hemorrhage related to reduce platelet aggregation
- Take w/ food or rectal
- Notify: blurry vision, n/v, ringing of ears, difficulty breathing
- Monitor neonate at birth
- Used for:
o Preterm Labor
Betamethasone – glucocorticoid, IM, 2 injections 24 hrs apart

- Enhance fetal lung maturity and surfactant production in fetus between 24-34 wks
- Report finding of pulmonary edema
- Administer: Preterm
o 12mg IM for 2 doses 24hrs apart
o No more than 7 days before delivery
o IM ventral gluteal or vastus lateralis m.
o Monitor maternal hypergly
▪ Newborn baby – predispose for hypoglycemia
▪ Blood glucose should be checked within the 1st hour and frequently until BG is normal
o Assess the preterm infant lungs
- Single dose is given w/ PROM & PPROM @ 24-34 wk to reduce risk of perinatal mortality, respiratory distress syn
- Used for:
o Placenta previa
o Preterm Labor
o Premature rupture of membrane (PROM) and preterm rupture of membrane(PPROM)
Ampicillin- antibiotic Gestational hypertension medications
- Chorioamnionitis - Methyldopa
- GBS - Nifedipine
- Premature rupture of membrane and preterm rupture - Hydralazine
of membrane - Labetalol
Postpartum Hemorrhage
Methylergonovine- Uterine stimulant Misoprostol- Uterine stimulant
- Controls post partum hemorrhage - Controls postpartum Hemorrhage

- Assess uterine tone and vag bleeding. - Assess uterine tone and vag bleeding
- Do NOT administer to pt’s with Hypertension
-Cervical ripening/ Induction of labor
- Adverse effects: Hypertension, n/v, headache
- void prior to procedure
Tablet inserted into vagina to ripen the cervix
Give oxytocin 4 hours after
Carbroprost Tromethamine- Uterine stimulant Methylergonovine- Uterine Stimulating
- Controls postpartum Hemorrhage - To promote uterine contractions and expel retained

- Assess uterine tone and vag bleeding fragments of placenta
- Adverse Effects: fever, hypertension, chills, headache, - Assess Uterine tone an vag bleeding
n/v/d - Signs of infections such as increased uterine
tenderness
- Antibiotic therapy – to prevent or treat infections.
Oxytocin- uterine stimulant
Ante Post
- Augment labor and strengthen uterine contractions - Promotes uterine contractions and expels the retained
o Dystocia ( dysfunctional labor) fragments of placenta
- increasing intensity and duration of contractions. - Assess uterine tone, vag bleeding, flaccid uterus
- Oxytocin is NOT administered for hypertonic - Adverse effects: water intoxication- lightheadness,
contractions (cannot indented, even btwn n/v, headache, malaise
contractions) o Cerebral edema- seizures, coma, death
o Oxytocin can lead to hypertonic uterine - Used: postpartum hemorrhage, retained placental
contractions

Antidote: Calcium Gluconate or Calcium Chloride: Excessively Frequent Uterine Contractions During Pregnancy

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ATI Maternal Medications

Nifedipine – CCB, suppress contractions by inhibiting calcium from entering smooth m.

- Monitor for headache, flush, dizziness, nausea

- Can cause premature narrowing or closure of ductus arteriosus in the fetus

Betamethasone – glucocorticoid, IM, 2 injections 24 hrs apart

Methylergonovine- Uterine stimulant Misoprostol- Uterine stimulant

- Controls post partum hemorrhage - Controls postpartum Hemorrhage

Tablet inserted into vagina to ripen the cervix

Give oxytocin 4 hours after

Carbroprost Tromethamine- Uterine stimulant Methylergonovine- Uterine Stimulating

- Controls postpartum Hemorrhage - To promote uterine contractions and expel retained

Oxytocin- uterine stimulant

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