Question:
Which drug is not used to control bleeding during delivery of a woman with heart disease?
Which drug is not used to control bleeding during delivery of a woman with heart disease?
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Avoid the ergot alkaloid that spikes blood pressure and afterload.
Updated On: Jun 24, 2026
- Methylergometrine
- Carboprost
- Syntocinon (oxytocin)
- Misoprostol
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The Correct Option is A
Solution and Explanation
Step 1: Identify the clinical setting. A woman with cardiac disease has limited reserve, so any uterotonic that significantly raises blood pressure or systemic vascular resistance is hazardous.
Step 2: Methylergometrine (an ergot alkaloid) causes generalised vasoconstriction and a marked rise in blood pressure. This increases cardiac afterload and can precipitate cardiac failure, so it is contraindicated in cardiac patients (as well as in hypertension and pre-eclampsia).
Step 3: Compare the alternatives. Oxytocin (syntocinon) is the standard first-line uterotonic; carboprost (a prostaglandin F2-alpha analogue) and misoprostol (a prostaglandin E1 analogue) are used for postpartum haemorrhage and are acceptable where ergometrine is unsafe.
Step 4: Therefore the drug to avoid is methylergometrine, option A.
Step 2: Methylergometrine (an ergot alkaloid) causes generalised vasoconstriction and a marked rise in blood pressure. This increases cardiac afterload and can precipitate cardiac failure, so it is contraindicated in cardiac patients (as well as in hypertension and pre-eclampsia).
Step 3: Compare the alternatives. Oxytocin (syntocinon) is the standard first-line uterotonic; carboprost (a prostaglandin F2-alpha analogue) and misoprostol (a prostaglandin E1 analogue) are used for postpartum haemorrhage and are acceptable where ergometrine is unsafe.
Step 4: Therefore the drug to avoid is methylergometrine, option A.
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