A woman delivers vaginally and develops atonic postpartum hemorrhage. Her blood pressure is 170/112 mmHg with 3+ proteinuria and she is actively convulsing. Which uterotonic agent must be avoided in her management?

• A Oxytocin infusion
• B Misoprostol sublingual
• C Carboprost tromethamine
• D Methylergometrine ✓

Explanation

Ergot alkaloids such as methylergometrine cause sustained smooth muscle contraction of vessels and uterus, producing dangerous hypertension. They are contraindicated in preeclampsia, eclampsia, and chronic hypertension. Oxytocin, misoprostol, and carboprost do not raise blood pressure significantly; carboprost's main contraindication is asthma, making it acceptable here provided the airway allows prostaglandin use.

Reference: DC Dutta's Textbook of Obstetrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.