Question

A 26-year-old G1P0 parturient at term delivers a 3,500-g boy vaginally. After 30 minutes the obstetrician grows concerned that the placenta has not yet delivered. The patient is transferred to an operating room and positioned for manual extraction of the placenta. Aft er the placenta is removed, the obstetrician notices brisk uterine bleeding. All of the following medications would be contraindicated in the specific condition identifi ed EXCEPT

A. Methylergonovine, 200 micrograms IM: Severe preeclampsia
B. Carboprost (15-methyl-PGF2. ), 250 micrograms IM: History of severe asthma
C. Oxytocin, 10 units IV: Uncorrected maternal hypovolemia
D. Misoprostol, 1,000 micrograms: Maternal fever
E. All of the above are appropriate contraindications.

Answer 1

The correct answer is C. Oxytocin, 10 units IV, because it does not have a contraindication that would prevent its use in this case of postpartum hemorrhage once maternal hypovolemia is corrected. Oxytocin is commonly used to enhance uterine contractions and manage bleeding post-delivery.

Step-by-step explanation:

The question pertains to a 26-year-old G1P0 woman who has given birth vaginally to a 3,500-gram boy and is experiencing a retained placenta, which is posing a risk for postpartum hemorrhage. After the manual removal of the placenta, she has brisk uterine bleeding. The question presents various medications and their contraindications in certain conditions.

The correct answer to the question is C. Oxytocin, 10 units IV. Unlike the other medications listed, oxytocin does not have a specific contraindication mentioned (uncorrected maternal hypovolemia), which would exclude its use in the management of postpartum hemorrhage in this scenario. It is important to correct hypovolemia before administering oxytocin. However, once corrected, oxytocin can be administered safely and is commonly used to encourage uterine contractions and help control bleeding.