Podcast: Play in new window | Download (Duration: 40:05 — 36.7MB)
Subscribe: Google Podcasts | RSS | More
This week I am joined again by Nolan who was involved in writing the recently published international consensus guidelines on the use of uterotonic drugs at caesarean section. We discuss the pharmacology and mechanisms of all the different drugs used in clinical practice. From a practical point of view these guidelines differentiate between oxytocin naive women, those who have been exposed to oxytocin (in labour) and those practitioners working in less well resourced settings.
A big thank you to Trilby for helping to setup the new audio equipment! Hopefully the quality of these podcasts will start to improve over the next few episodes as we get to grips with how to use all this new stuff!
International consensus statement on the use of uterotonic agents during caesarean section. https://onlinelibrary.wiley.com/doi/full/10.1111/anae.14757
Thanks for great summary. Any comments on use of uterotonics, especially 2nd line agents, in women with valvular heart disease? ( who may also have occult/early IHD askciated with smoking, poorly controlled diabetes etc)
Thanks Siew-Lee, I have asked Nolan for a comment as well, but I would just try and relate each patient and keep in mind the potential problems / side effects of each of the second line agents. For example if a woman had serious pulmonary hypertension as a consequence of her valvular problems (eg severe mitral stenosis from rheumatic heart disease) then I would be very reluctant to use carboprost which causes pulmonary vasoconstriction. But if someone only had a mild valvular problem and no pulm HTN and was bleeding a lot it might make sense to try some carboprost? The devil’s in the detail is the correct expression probably! Anyone else out their want to comment on this question also?