Tugas KONKLI

Dr. dr. Nugraha U. P , Sp.OG(K)

• Augmentation of labour is the process of stimulating the uterus to increase
the frequency, duration and intensity of contractions after the onset of
spontaneous labour. It has commonly been used to treat delayed labour when
uterine contractions are assessed to be insufficiently strong or inappropriately
coordinated to dilate the cervix. Labour augmentation has traditionally been
performed with the use of intravenous oxytocin infusion and/or artificial
rupture of amniotic membranes (amniotomy).
• While augmentation of labour may be beneficial in preventing prolonged
labour, its inappropriate use may cause harm. Augmentation with synthetic
oxytocin may result in uterine hyperstimulation, with adverse effects such as
fetal asphyxia and uterine rupture, and thus increase the risk of a cascade of
interventions during labour and delivery.
Methods of Labor Augmentation
Medical Surgical Combination of both
Oxytocin infusion Amniotomy – artificial Amniotomy with oxytocin
rupture of the membranes
Oxytocin Dose in Augmentation of Labor

5 unit 500 mL
10 mU/mL
Oxytocin Crystalloid

1 mL 20 tetes 1 tetes 0,5 mU

Faktor Tetesan
 Jumlah
Tetesan Kecepatan
Menit Ke- /Menit cairan (mU/menit)
(cc)
1-30 8 12 4
30-60 12 18 6
60-120 16 24 8
120-180 20 30 10
180-240 24 36 12
Drips oxytocin 5 IU dalam 500 mL Ringer Laktat 240-300 28 42 14
mulai 8 tpm, dinaikkan 4 tetes setiap 30 menit 300-360 32 48 16
sampai his adekuat (maksimal 40 tpm)
360-420 36 54 18
420-480 40 60 20
  𝐽𝑢𝑚𝑙𝑎h 𝑐𝑎𝑖𝑟𝑎𝑛 𝑥 𝐹𝑎𝑘𝑡𝑜𝑟 𝑡𝑒𝑡𝑒𝑠𝑎𝑛
𝑡𝑒𝑡𝑒𝑠𝑎𝑛 𝑝𝑒𝑟 𝑚𝑒𝑛𝑖𝑡 =
𝑊𝑎𝑘𝑡𝑢 𝑝𝑒𝑚𝑏𝑒𝑟𝑖𝑎𝑛 (𝑚𝑒𝑛𝑖𝑡 )
Maximal Oxytocin Dosage

The maximal efective dose of oxytocin to achieve adequate

contractions in all women is diferent

Thus, if contractions are not adequate-less than 200 Montevideo units-

and if the fetal status is reassuring and labor has arrested, an oxytocin
infusion dose greater than 48 mU/min has no apparent risks.
TERIMAKASIH