A 28-year-old woman develops severe atonic postpartum hemorrhage after vaginal delivery. Oxytocin infusion fails to control the bleeding and she has no history of asthma or hypertension. Which drug is most appropriate next?
- A Ergometrine intravenously
- B Carboprost intramuscularly ✓
- C Mifepristone orally
- D Atosiban intravenously
Correct answer: B. Carboprost intramuscularly
Explanation
Carboprost is a PGF2alpha analog that causes sustained uterine contraction and is a standard third-line agent for atonic PPH. Its main contraindications are asthma (bronchospasm) and hypertension. Ergometrine causes vomiting and rises in blood pressure but is usually given earlier; mifepristone is an abortifacient antiprogestogen; atosiban is a tocolytic oxytocin antagonist used to stop preterm labor, which would be actively harmful here.
Reference: KD Tripathi Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.