A preeclamptic woman with blood pressure of 170/112 mmHg develops atonic postpartum hemorrhage after vaginal delivery. Which uterotonic agent should be avoided in her?
- A Methylergometrine ✓
- B Oxytocin infusion
- C Misoprostol
- D Tranexamic acid
Correct answer: A. Methylergometrine
Explanation
Ergot alkaloids such as methylergometrine produce sustained smooth muscle contraction of both uterus and vascular smooth muscle, causing hypertension and even cerebrovascular events. They are contraindicated in preeclampsia, eclampsia, and chronic hypertension. Oxytocin, misoprostol, and tranexamic acid do not raise blood pressure significantly, though carboprost is limited by asthma instead. This distinction between ergometrine (hypertension) and carboprost (asthma) is a favorite examination pairing.
Reference: Williams Obstetrics, 25th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.