Chapter 29: Maternity and Newborn Medications

For pregnancy complications, tocolytics such as indomethacin and nifedipine suppress uterine contractions to arrest preterm labor, though tocolytics require careful monitoring for maternal and fetal adverse effects. Magnesium sulfate functions as a central nervous system depressant utilized for both preterm labor inhibition and seizure prophylaxis in preeclampsia, necessitating vigilant assessment for toxicity signs including respiratory depression and diminished deep tendon reflexes, with calcium gluconate maintained as the reversal agent. Antenatal corticosteroids administered between 28 and 32 weeks gestation accelerate fetal pulmonary maturity by promoting surfactant production, significantly reducing neonatal respiratory distress risk. Labor management incorporates opioid analgesics for pain control alongside prostaglandins and oxytocin for cervical ripening and uterine stimulation, with oxytocin requiring continuous fetal monitoring and immediate discontinuation if hyperstimulation develops. Postpartum hemorrhage management relies on uterotonic agents including methylergonovine, which produces sustained tetanic contractions but carries vasoconstriction risks contraindicated in hypertensive clients, and carboprost, which presents contraindications for asthmatic patients. Immunologic protection includes Rho(D) immune globulin administration to Rh-negative mothers and rubella vaccination to nonimmune individuals. Newborn care protocols encompass exogenous surfactant replacement for respiratory distress prevention, ophthalmic erythromycin for gonococcal and chlamydial prophylaxis, intramuscular phytonadione to prevent hemorrhagic disease, and hepatitis B immunization with corresponding immune globulin administration when maternal infection is present. The chapter concludes by addressing family planning interventions, including hormonal contraceptive mechanisms and fertility-promoting agents, while acknowledging potential risks and drug interactions affecting contraceptive efficacy.