Which drug is used in Postpartum Hemorrhage?

Raj. CHO -2020

Obstetrics & Gynaecology

Easy

Appeared in: Raj. CHO -2020

Explanation

Oxytocin is the recommended first-line uterotonic agent for both the prevention and treatment of postpartum hemorrhage (PPH) by the World Health Organization (WHO).
It acts on oxytocin receptors in the myometrium, causing the uterus to contract powerfully.
These contractions constrict the spiral arteries at the placental implantation site, which is the primary mechanism for controlling postpartum bleeding.
It is a crucial component of the Active Management of the Third Stage of Labor (AMTSL) to prevent PPH.

Option B: While Methergin (methylergonovine) is a potent uterotonic used for PPH, it is considered a second-line agent, not the primary choice.
Option C: Mifepristone is not used to treat active postpartum hemorrhage. Its mechanism is to block progesterone receptors, which is useful for medical termination of pregnancy or cervical ripening, not for inducing immediate, strong uterine contractions to stop bleeding.
Option D: Misoprostol, a prostaglandin, is also a second or third-line agent for PPH. It is less effective than oxytocin for PPH prevention.

Visual 1: Infographic: A flowchart showing the stepwise management of PPH, starting with fundal massage and first-line uterotonics (Oxytocin), and progressing to second-line agents (Methergin, Misoprostol) and other interventions.
Visual 2: Diagram: An illustration showing the mechanism of action of different uterotonic drugs on the uterine myometrium.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological management of Postpartum Hemorrhage (PPH) to guide bedside assessment, documentation, and the next nursing action.
Prompt recognition and management of PPH are critical nursing skills to prevent maternal morbidity and mortality. Knowing the first-line drug is essential for rapid intervention.
Nurses must be aware of the contraindications for each uterotonic drug. For example, administering Methergin to a hypertensive patient can lead to a dangerous spike in blood pressure.
The nurse's role includes not only administering the medication but also continuously assessing the patient's response: monitoring uterine tone, vital signs, and the amount of bleeding.

How to Approach the Question

This is a factual recall question asking for a drug used in a specific condition.
First, identify the condition: Postpartum Hemorrhage (PPH).
Recall the primary treatments for PPH. Several drugs (uterotonics) are used to make the uterus contract.
Evaluate the options provided. All except Mifepristone are used for PPH.
In a single-best-answer question, when multiple options are technically correct, identify the first-line or most recommended treatment.
Oxytocin is universally recognized as the first-line drug for PPH management. Therefore, it is the best answer.

Concept Tested & Keywords

Concept Tested: Pharmacological management of Postpartum Hemorrhage (PPH).
Stem keywords: drug, Postpartum Hemorrhage
Lead-in keywords: Which
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

QnNeIpD5Pr3NEpkMhJRGUw