Medication SummaryMedications used to control postpartum hemorrhage (PPH) are in the category of uterotonic drugs. These drugs stimulate contraction of the uterine muscle, helping to control PPH. Show
UterotonicsClass SummaryThese agents are useful in the treatment and prophylaxis of PPH. The information below applies only following delivery of the fetus (the dosing, indications, and contraindications will vary prior to delivery). Oxytocin (Pitocin)
Produces rhythmic uterine contractions, can stimulate the gravid uterus, and has vasopressive and antidiuretic effects. Can be used to control postpartum bleeding or hemorrhage. Some suggest its prophylactic use in the third stage of labor; one study of 1000 deliveries revealed a 32% reduction in the rate of PPH. Methylergonovine (Methergine)
Acts directly on uterine smooth muscle, causing a sustained tetanic uterotonic effect that reduces uterine bleeding and shortens the third stage of labor. Administer IM or intramyometrially during puerperium, during delivery of placenta, or after delivering anterior shoulder. Carboprost (Hemabate)
Prostaglandin similar to F2-alpha, but it has a longer duration and produces myometrial contractions that induce hemostasis at the placentation site, which reduces postpartum bleeding. Misoprostol (Cytotec)
Synthetic prostaglandin E 1 analog. Ergonovine (Ergotrate Maleate)
Used to prevent and treat PPH due to uterine atony by producing firm contraction of the uterus within minutes. Although it is intended primarily for IM administration, a faster response can be achieved with IV use. Compared with IM route, IV route has a higher incidence of adverse effects; IV use should be reserved for emergencies (eg, excessive uterine bleeding). Severe uterine bleeding may require repeated doses, but it seldom requires more than one injection q2-4h. Recombinant factor VIIa (NovoSeven)
Man-made activated protein that promotes thrombosis.
Author Maame Yaa A B Yiadom, MD, MPH Staff Physician, Department of Emergency Medicine, Cooper University Hospital, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School Maame Yaa A B Yiadom, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, National Medical Association, Society for Academic Emergency Medicine Disclosure: Nothing to disclose. Coauthor(s) Daniela Carusi, MD, MSc Instructor, Obstetrics and Gynecology and Reproductive Biology, Harvard Medical School; Consulting Physician, Department of Obstetrics and Gynecology, Medical Director, Department of General Ambulatory Gynecology, Brigham and Women's Hospital Daniela Carusi, MD, MSc is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Reproductive Health Professionals, Massachusetts Medical Society Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Mark L Zwanger, MD, MBA, FACEP Emergency Medicine Physician Mark L Zwanger, MD, MBA, FACEP is a member of the following medical societies: American College of Emergency Physicians Disclosure: Nothing to disclose. Chief Editor Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE Chief, Department of Emergency Medicine, Sentara Norfolk General Hospital; Medical Ditector, Sentara Transfer Center; Professor and Assistant Program Director, Core Academic Faculty, Department of Emergency Medicine, Eastern Virginia Medical School; Board Member, American Academy of Emergency Medicine Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE is a member of the following medical societies: American Academy of Emergency Medicine, American Association for Physician Leadership, American College of Emergency Physicians, American College of Healthcare Executives, American Institute of Ultrasound in Medicine, Emergency Nurses Association, Medical Society of Virginia, Norfolk Academy of Medicine, Society for Academic Emergency Medicine Disclosure: Nothing to disclose. Additional Contributors Acknowledgements Special thanks to Dr. Donnie Bell for his assistance with the "Imaging" section for this topic. The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the contributions of previous author, Michael P Wainscott, MD, to the development and writing of this article. What drugs promote uterine relaxation?The first were antispasmodic drugs, such as hyoscine. Later, myometrial relaxants, often referred to as tocolytic agents, became popular. These included isoxsuprine, ritodrine, and salbutamol. In the past, the use of both antispasmodic and tocolytic drugs was widely advocated.
Which class of drugs is used to prevent contraction of the uterus?Oxytocin antagonists as tocolytics
By preventing oxytocin binding this stimulation of uterine contractions should be inhibited.
Is oxytocin a uterine relaxant?The resultant need for a higher oxytocin dose to cause adequate uterine contraction in vivo has also been demonstrated in laboring women having received oxytocin for labor augmentation. Achieving rapid uterine relaxation can be invaluable for maternal and fetal wellbeing in some acute obstetric emergency settings.
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Which of the following medications would be given to promote uterine relaxation?
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