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Uterine atony

Most common cause of postpartum hemorrhage. Treated with synthetic oxytocins (ex. oxytocin injection, Pitocin®), which do NOT contain vasopressin – if given rapidly (ex. 10 U Pitocin® rapidly, despite that the manufacture recommends only 5 U slowly), these agents can cause vasodilation/hypotension and tachycardia [Pinder AJ et al. Int J Obstetr Anesth 11: 156, 2002]. 10 – 15 units should be given in 500 cc of crytalloid, slowly titrated to effect. If unhelpful, consider methylergonovine (0.2 mg IM, contraindicated in preeclampsia), prostaglandin F2α (0.25 mg IM, may increase airway resistance), or misoprostol (prostaglandin E1 analog)

Uterine Atony

10-20 U Pitocin® infusion over 10 mins

Methylergonovine 0.2 mg IM (contraindicated in preeclampsia)

Prostaglandin F2α (0.25 mg IM, may increase airway resistance)


Other References

  1. Hemorrhage (Obstetrics) Link
  2. Keys to the Cart: November 21, 2016; A 5-minute video review of ABA Keywords Link