American Board of Family Medicine (ABFM) Practice Exam

Which medication is commonly used to treat uterine atony and postpartum hemorrhage?

1. Carboprost (Hemabate)

2. Methylergonovine

3. Misoprostol (Cytotec)

4. Oxytocin (Pitocin)

The correct answer is: Carboprost (Hemabate)

The most commonly used medication to treat uterine atony and postpartum hemorrhage is Oxytocin (Pitocin). Oxytocin acts as a powerful uterotonic agent that stimulates uterine contractions, which helps to reduce bleeding following childbirth. By promoting muscle contractions in the uterus, it effectively decreases the risk of postpartum hemorrhage associated with uterine atony, a condition where the uterus fails to contract adequately after delivery. Other medications listed have their respective uses; for instance, Carboprost (Hemabate) is typically used for severe cases of uterine atony and is especially effective in cases where traditional treatments like oxytocin are insufficient. Methylergonovine is also a uterotonic but is usually reserved for second-line treatment due to potential hypertensive effects, making oxytocin the first-line treatment specific for immediate use in postpartum situations. Misoprostol is quite effective as well but is generally used in settings where oxytocin cannot be administered, such as in home births or developing countries where access to intravenous therapies is limited. Overall, while there are effective alternatives, Oxytocin remains the most commonly utilized initial agent due to its established efficacy and safety profile in managing uterine atony and preventing postpartum hemorrhage.