Managing Complications in Pregnancy and Childbirth: - IAWG

Vaginal bleeding after childbirthS-29MANAGEMENTATONIC UTERUSAn atonic uterus fails to contract after delivery.• Continue to massage the uterus.• Use oxytocic drugs which can be given together or sequentially(Table S-8).TABLE S-8Use of oxytocic drugsOxytocinDose and route IV: Infuse 20units in 1 L IVfluids at 60drops per minuteErgometrine/MethylergometrineIM or IV(slowly): 0.2 mg15-methylProstaglandinF 2"IM: 0.25 mgContinuingdoseIM: 10 unitsIV: Infuse 20units in 1 L IVfluids at 40drops per minuteMaximum dose Not more than 3L of IV fluidscontainingoxytocinPrecautions/ContraindicationsDo not give as anIV bolusRepeat 0.2 mgIM after 15minutesIf required, give0.2 mg IM or IV(slowly) every 4hours5 doses (Total1.0 mg)Pre-eclampsia,hypertension,heart disease0.25 mg every 15minutes8 doses (Total2 mg)AsthmaProstaglandins should not be given intravenously. They may befatal.