First DOC for atonic PPH is :
Correct Answer: Oxytocin
Description: Ans. is 'b' i.e., Oxytocin * As per WHO & ACOG guidelines OXYTOCIN is the first line DOC for atonic PPH* Rapid, continuous infusion of dilute IV oxytocin (40-80 U) in 1L NS to be started.# Methergine: 0.2 mg IM repeat every 5 mins as needed up to 5 doses.# The 15-methyl derivative of prostaglandin F2a (carboprost tromethamine) is used for uterine atony. The initial recommended dose is 250 mg (0.25 mg) given intramuscularly, and this is repeated if necessary at 15-90 min intervals up to a maximum of eight doses. It can also be given intramyometrial.# Misoprostol, a synthetic prostaglandin El analog, is also effective for the treatment of uterine atony. 800- 1000mg can be used per rectally.# PGE2 (Dinoprostone) 20mg suppository (PR or PV route) every 2 hours can also be used.# An intravenous bolus of 10 units of oxytocin causes a transient but marked fall in arterial blood pressure that is followed by an abrupt increase in cardiac output.# Oxytocin should not be given intravenously as a large bolus, but rather as a much more dilute solution by continuous intravenous infusion or as an intramuscular injection.
Category:
Gynaecology & Obstetrics
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