Poor use of uterotonics, especially ergometrine
to prevent and treat uterine atony at CS
For decades, oxytocin and ergometrine
have been the treatments of choice for PPH, but both drugs can be given only by injection and require refrigeration.
was given and she suffered an eclamptic seizure shortly after.
Oxytocin has the advantage over ergometrine
that it is not degraded by direct light and need not be kept continuously in a fridge.
The Czech Republic is a producer of ergometrine
and ergotamine used for the production of LSD.
amiodarone, flecainide, propafenone, quinidine, astemizole, terfenidine, ergometrine
, ergotamine, cisapride, pimozide, triazolam, simvastatin, lovastatin).
Controlled substances include Pseudoephedrine, Ergometrine
and others listed in an annex to the legislation.
There was grossly substandard care in 60% of cases, including failure to secure haemostasis at the initial CS, non-use of potentially effective treatment such as parenteral ergometrine
, uterine compression sutures and balloon tamponade, and delays in definitive management such as hysterectomy.
If oxytocin is unavailable, ergometrine
or the fixed drug combination of oxytocin and ergometrine
should be used, except in women with hypertension or heart disease.
Poor practices included inadequate monitoring during labour, with no routine use of the partogram, and the use of unrefrigerated ergometrine
in the third stage of labour.