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What is A 30-year-old G3P2 woman with a history of hypertension presents to the birthing floor in labor. Following a prolonged labor and delivery with no fetal complications, she continues to bleed vaginally but remains afebrile. On bimanual examination, her uterus is soft, boggy, and enlarged. There are no visible lacerations. Uterine massage only slightly decreases the hemorrhage, and oxytocin is only mildly effective. Which of the following is the next best step in mgt: and explain in detail?
This is a case of Atonic PPH as the patient has presented with vaginal bleeding immediately after delivery and uterus is not palpable per abdominally, i.e it has lost its tone.
In Atonic PPH the first step in management should be uterotonic agents like oxytocin or methylergometrine and if bleeding is not controlled by using either of it, straightaway PGF2a i.e carboprost should be used.