Which medication is the first-line uterotonic given by intramuscular injection in the postpartum hemorrhage protocol?

Which medication is the first-line uterotonic given by intramuscular injection in the postpartum hemorrhage protocol?

• A. Methylergonovine IM
• B. Prostaglandin F2 Alpha IM
• C. Pitocin 10 Units IM Lateral Thigh
• D. Terbutaline IM

Answer: (C)

In postpartum hemorrhage management, the primary goal is to restore uterine tone quickly to compress the placentalSite vessels and reduce bleeding. The best first-line uterotonic is oxytocin, given as 10 units intramuscularly (Pitocin). Oxytocin stimulates uterine contractions by acting on oxytocin receptors in the myometrium, producing a rapid response that helps control blood loss with a favorable safety profile and wide availability. Other options have important roles but are not first-line. An ergot alkaloid uterotonic can be used if oxytocin isn't enough, but it raises blood pressure and has more contraindications. A prostaglandin even more strongly contracts the uterus but comes with more side effects and specific contraindications, so it’s typically a secondary choice. A tocolytic like terbutaline is used to stop contractions, not to promote them, so it would not help in this scenario.

In postpartum hemorrhage management, the primary goal is to restore uterine tone quickly to compress the placentalSite vessels and reduce bleeding. The best first-line uterotonic is oxytocin, given as 10 units intramuscularly (Pitocin). Oxytocin stimulates uterine contractions by acting on oxytocin receptors in the myometrium, producing a rapid response that helps control blood loss with a favorable safety profile and wide availability.

Other options have important roles but are not first-line. An ergot alkaloid uterotonic can be used if oxytocin isn't enough, but it raises blood pressure and has more contraindications. A prostaglandin even more strongly contracts the uterus but comes with more side effects and specific contraindications, so it’s typically a secondary choice. A tocolytic like terbutaline is used to stop contractions, not to promote them, so it would not help in this scenario.