Mechanism
In method of action, the preparation is identical to that of caffeine base as the citrate counter ion dissociates in water. Doses of caffeine citrate, due to the added weight of the citrate moiety, are understandably higher than with caffeine base, i.e., it takes a larger dose to get the same amount of caffeine. The ratio of therapeutic doses of caffeine base to its citrate salt is typically 1:2. Dosing should therefore be clearly distinguished. Manufacture
The drug is prepared by combining anhydrous caffeine with citric acid monohydrate and sodium citrate dihydrate. Caffeine citrate cocrystals can take on at least two anhydrous polymorphs. References
External links
"Caffeine citrate". Drug Information Portal. U.S. National Library of Medicine. "Caffeine Citrate (CUI C0054436)". NCI Metathesaurus.
A score of 4/10 or less is considered abnormal, and delivery may be indicated. Low amniotic fluid can cause pinching umbilical cord, decreasing blood flow to the fetus. Therefore, a score of 0 points for amniotic fluid may indicate the fetus is at risk. Management
Expectant
A woman who has reached 42 weeks of pregnancy is likely to be offered induction of labour. Alternatively, she can choose expectant management, that is, she waits for the natural onset of labour. Women opting for expectant management may also choose to carry on with additional monitoring of their baby, with regular CTG, ultrasound, and biophysical profile. Risks of expectant management vary between studies.In many places in the World, according to the World Health Organization and others, such services are rudimentary or not available, and deserve improvement. Inducing labor
Inducing labor artificially starts the labor process by using medication and other techniques. Labor is usually only induced if there is potential danger on the mother or child. There are several reasons for labor induction; the mothers water breaks, and contractions have not started, the child is postmature, the mother has diabetes or high blood pressure, or there is not enough amniotic fluid around the baby. Labor induction is not always the best choice because it has its own risks. Sometimes mothers will request to be induced for reasons that are not medical. This is called an elective induction. Doctors try to avoid inducing labor unless it is completely necessary. Procedure
There are four common methods of starting contractions.