A 31-year-old woman develops PPH after vaginal delivery. She has received oxytocin infusion, carboprost 250 mcg IM, and misoprostol 800 mcg rectally. Bleeding continues at 1500 mL. The uterus remains atonic. According to the RCOG Green-top Guideline, what is the recommended maximum total dose of carboprost (Hemabate) that can be administered?
- A 1 mg
- B 2 mg ✓
- C 3 mg
- D 4 mg
Correct answer: B. 2 mg
Explanation
The maximum recommended total dose of carboprost is 2 mg, given as 250 mcg IM every 15-90 minutes, up to 8 doses. Exceeding this dose increases the risk of bronchospasm, hypertension, and pulmonary edema. This is a frequently tested dose limit in Indian PG exams.
Reference: RCOG Green-top Guideline No. 52, 2016 (updated 2017) ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.