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Paper II — 2025 March (Supplementary (SAY)) (2019 Scheme) — Q4

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Paper II
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min

Question

Classify uterine stimulants and relaxants with suitable examples. Explain the rationale for the use of oxytocin in prevention of postpartum haemorrhage (PPH). (4+2)

Q46 marksShort Essays

Answer

Classification of uterine stimulants and relaxants

CategoryGroupExamples
Stimulants (Oxytocics)Peptide hormoneOxytocin
Ergot alkaloidsErgometrine, Methylergometrine
ProstaglandinsDinoprostone, Misoprostol, Carboprost
Relaxants (Tocolytics)Beta-2 agonistsTerbutaline, Ritodrine
Calcium channel blockersNifedipine
Oxytocin receptor antagonistAtosiban
OthersMagnesium sulfate

Rationale for oxytocin in PPH prevention Given routinely as part of active management of the third stage of labour (immediately after delivery of the anterior shoulder or the baby), oxytocin produces controlled, sustained uterine contraction that compresses the spiral arteries at the placental bed, reducing blood loss as the placenta separates. Its short half-life and titratable IV/IM administration allow controlled, reversible uterine stimulation, and it has a more favorable safety profile than ergometrine (which is contraindicated in hypertension/pre-eclampsia) — making it the first-line agent for PPH prophylaxis in essentially all patients, not just those without hypertensive risk factors.

  1. 1Gonadal Hormones and Related Drugs

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