Facharzt FMH Gynäkologie Und Geburtshilfe Practice Questions - Facharzt FMH Für Gynäkologie Und Geburtshilfe Spécialiste FMH En Gynécologie Et Obstétrique Exam

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A 31-year-old P2G2 woman delivers a 4,100 g infant vaginally following a 10-hour labor augmented with oxytocin. Ten minutes after delivery of the placenta, brisk vaginal bleeding is noted, totaling approximately 800 mL within 5 minutes. On abdominal palpation, the uterine fundus is soft, boggy, and located 3 cm above the umbilicus. Continuous uterine massage is initiated. What is the most appropriate next pharmacotherapy step according to SGGG postpartum hemorrhage (PPH) guidelines?

Administer oral methylergometrine 0.2 mg and await response before giving parenteral agents Administer intramuscular carboprost tromethamine (15-methyl PGF2alpha) 250 µg as the sole first-line agent Administer intravenous recombinant factor VIIa immediately as first-line hemostatic therapy Administer intravenous oxytocin (bolus of 5–10 IU slowly or infusion of 20–40 IU in 500 mL saline) plus intravenous tranexamic acid 1 g within 3 hours of birth

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Administer intravenous oxytocin (bolus of 5–10 IU slowly or infusion of 20–40 IU in 500 mL saline) plus intravenous tranexamic acid 1 g within 3 hours of birth

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