Pregnancy: Asthma + uterine atony
MGMT – initial interventions include : fundal massage, IV access, lab tests.
uterotonic drugs: oxytocin 40 units in 1 liter, methylergonovine 0.2 mg intramuscularly never IV, Misoprostol PGE1, Carboprost tromethamine – 15 methyl-PGF2alpha – Hemabate – 250 mcg IM every 15-90 min. If no asthma!
Hemabate has been shown to incite as well as exacerbate asthma . Thus, its use in asthmatic patients should be very carefully considered.