Chapter 27: Maternity and Newborn Medications

Corticosteroid therapy, particularly betamethasone and dexamethasone, accelerates fetal lung development when preterm delivery is anticipated, improving neonatal respiratory outcomes. The chapter details opioid analgesics used during labor—including meperidine, fentanyl, and nalbuphine—along with their maternal and neonatal effects and circumstances where they are contraindicated, as well as naloxone's role in reversing opioid-induced respiratory depression in newborns. Prostaglandin medications like misoprostol and dinoprostone facilitate cervical softening and labor initiation, while oxytocin serves dual functions in labor augmentation and controlling postpartum uterine hemorrhage. Uterine stimulants such as methylergonovine and carboprost provide sustained contraction to manage excessive bleeding after delivery. The chapter also addresses critical newborn interventions including prophylactic erythromycin for ophthalmia neonatorum prevention, phytonadione administration for vitamin K-dependent coagulation factor synthesis, hepatitis B vaccination protocols, and lung surfactant replacement therapy for infants with respiratory distress syndrome. Additionally, Rho(D) immune globulin administration for Rh-negative mothers prevents alloimmunization. Throughout, the chapter emphasizes safe medication administration, recognition of adverse effects, appropriate antidote availability, and evidence-based nursing actions during obstetric emergencies and neonatal resuscitation scenarios that are pertinent to licensure examinations.