Question

A 26-year-old primigravida at 39 weeks has postpartum uterine atony with estimated blood loss 1200 mL and tachycardia. After uterine massage and IV oxytocin, bleeding continues. Next best step?

Accepted Answer

Tranexamic acid IV within 3 hours of birth

Answer

Methylergonovine IM unless hypertensive

Answer

Carboprost IM (contraindicated in asthma)

Answer

Misoprostol sublingual only

Answer

Expectant management

Practice question

A 26-year-old primigravida at 39 weeks has postpartum uterine atony with estimated blood loss 1200 mL and tachycardia. After uterine massage and IV oxytocin, bleeding continues. Next best step?