Labor and Delivery in the Emergency Department Medication

Updated: Jun 07, 2022
  • Author: Thomas E Benzoni, DO, MT(ASCP); Chief Editor: Mark A Clark, MD  more...
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Medication Summary

Few drugs are needed in an uncomplicated delivery. If excessive bleeding occurs, first try massaging the uterus, because uterine atony is the most common cause of this complication. Do not try to push the uterus out the vaginal canal. Gently squeeze or compress the uterus to cause myofibrils to contract. This action compresses the vessels perforating the uterus. If this fails, try administering oxytocin (Pitocin), then prostaglandin F2.



Class Summary

These agents are used to reduce postpartum bleeding.

Oxytocin (Syntocinon, Pitocin)

Oxytocin produces rhythmic uterine contractions and can stimulate the gravid uterus; it has vasopressive and antidiuretic effects. Oxytocin can control postpartum bleeding or hemorrhage by increasing postpartum myometrial tonus.

Methylergonovine (Methergine)

Methylergonovine acts directly on uterine smooth muscle, causing a sustained tetanic uterotonic effect that reduces uterine bleeding and shortens the third stage of labor. Administer intramuscularly during puerperium, delivery of placenta, or after delivering the anterior shoulder. Methylergonovine may also be given intravenously, over at least 60 seconds, but it should not be administered routinely (may provoke hypertension or a stroke). Monitor blood pressure closely when administering intravenously.