A 30-year-old G1P0 undergoes cesarean section for fetal distress at 38 weeks. Her pre-operative Hb is 11 g/dL. She has no risk factors for PPH. According to WHO 2023 recommendations, the preferred uterotonic for prevention of PPH at cesarean section is:
- A Oxytocin 5 IU IV bolus alone
- B Carbetocin 100 mcg IV single dose ✓
- C Misoprostol 600 mcg sublingual
- D Ergometrine 0.5 mg IV
Correct answer: B. Carbetocin 100 mcg IV single dose
Explanation
Carbetocin (a long-acting oxytocin analogue) 100 mcg IV single dose is now the WHO-preferred uterotonic for prevention of PPH at cesarean section in settings where it is available, as it has a longer duration of action than oxytocin and eliminates the need for an infusion. Oxytocin bolus alone has a shorter duration; misoprostol and ergometrine are second-line agents. The heat-stable carbetocin formulation is particularly valuable in low-resource settings.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.