Following a Difficult Vaginal Birth of a Singleton Pregnancy, the Patient

question 29

Multiple Choice

Following a difficult vaginal birth of a singleton pregnancy, the patient starts bleeding heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because the uterine fundus is soft and displaced laterally from midline. Vital signs are 37.6°C (99.8°F) , pulse 90 beats/minute, respirations 20 breaths per minute, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated?

• A) Oxytocin (Pitocin) to be administered in a piggyback solution
• B) Administration of methylergonovine (Methergine)
• C) Administration of prostaglandin analog
• D) Increase in parenteral fluids

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