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. 2022 Oct 23;23(6):919–925. doi: 10.5811/westjem.2022.8.57929

Table 4.

Management of uterine atony.

Intervention Dosing, route, and side effects
Initial30 Bimanual massage
*Ensure that the placenta is evacuated completely
Medical

  1. Misoprostol 600 mcg SL or 1000 mcg PR46

  2. Methylergonovine 0.2 mg IM47

    *Avoid in patients with hypertension

  3. Carboprost 250 mcg IM48

    *Avoid in patients with asthma as well as cardiac, hepatic, pulmonary, and renal disease
Physical tamponade30,45

  1. Bakri balloon–fill with 500 mL of warm normal saline

  2. Foley balloon–fill with 50–60 mL

mcg, microgram; SL, sublingual; PR, by rectum; IM, intramuscular; ml, milliliter.