For women who experience a postpartum hemorrhage, and already have received oxytocin as part of routine obstetric care, prioritize the use of parenteral uterotonics, including oxytocin, methylergonovine, and carboprost tromethamine
, and avoid the use of rectal misoprostol
One of the most widely used Prostaglandin synthetic analogue is Carboprost Tromethamine
(15-methyl Prostaglandin F2a.) This drug when given intramuscularly for cervical priming, though effective, is associated with too many side effects.
The researchers observed that the median ERL was greater in cases that involved administration of misoprostol, methylergonovine, or carboprost tromethamine
Evaluation of carboprost tromethamine
in the treatment of cyclophosphamide-induced hemorrhagic cystitis.
Considerations during labor and delivery, when the risk of asthma exacerbations is increased, include avoiding the use of carboprost tromethamine
(Hemabate), a very potent bronchoconstrictor that could cause a "rip-roaring" attack.
From the third year onwards, we started using a prostaglandin (carboprost tromethamine
, 0.125-0.25 mg intramuscularly) to prime the cervix for pregnancies over eight weeks.
Manual massage of the uterus and administration of oxytocin, misoprostol, carboprost tromethamine
(Hemabate), and methergine do not result in resolution of the hemorrhage.
Prostin (dinoprostone) and Hemabate (carboprost tromethamine
) are agents that get the job done.
I have continued that regimen, adding carboprost tromethamine
(Hemabate) to the regimen about 10 years ago when hemorrhage persists.
If these methods are unsuccessful in correcting the atony, uterotonics such as a prostaglandin (rectally administered misoprostol [800 mg] or intramuscular carboprost tromethamine
[Hemabate; 250 [micro]g/mL]) will usually succeed.