As soon as the os is dilated, pituitrin may be given under due precautions, as hereafter indicated. Pituitrin has but little influence on the nonfunctionating organ, but acts well on a uterus which is definitely contracting. It should not be given during the first stage, since when the uterus contracts, there must be an adequate opening for the advance of the child. Five to seven minims is the usual dose, injected into the deltoid muscle. The injection may be repeated in an hour, if required, since the effects, which begin about five minutes after the injections, will pass off in fifty-five minutes.
By the use of pituitin many operative procedures are altered or avoided. A high forceps case may be converted into a case for the low instruments, and the latter in many instances avoided altogether.
The use of pituitin may be briefly summarized as follows:
Pituitrin
(Use no alcohol to cleanse syringe or skin before injection.)
Indications.—
1. Inertia uteri or weak, shallow pains in second stage.
2. Multiparity.
3. Post partum hæmorrhage.
4. To avoid use of forceps or to reduce a high forceps case to a low one.