A G3P2 woman delivers at 38 weeks and develops PPH due to uterine atony not responding to oxytocin and methylergometrine. Carboprost (15-methyl PGF2α) is being considered. Which of the following is the most important contraindication to carboprost in this scenario?

• A Gestational diabetes mellitus
• B Previous caesarean section scar
• C Previous PPH requiring blood transfusion
• D Maternal bronchial asthma ✓

Explanation

Carboprost (15-methyl prostaglandin F2α) causes bronchospasm by acting on prostaglandin receptors in bronchial smooth muscle — it is absolutely contraindicated in patients with asthma as it can precipitate a severe, life-threatening asthma attack. It is also contraindicated in cardiac, hepatic, renal, and pulmonary disease. Gestational diabetes, previous caesarean scar, and history of PPH are not contraindications. Misoprostol (PGE1) is a safer alternative in asthmatic patients.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.