Complications and emergencies: ergometrine in hypertensive disease: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Complications and emergencies: ergometrine in hypertensive disease

Sample item

A woman with severe pre-eclampsia and blood pressure 170/110 mmHg has atonic postpartum haemorrhage after delivery. Which drug given for postpartum haemorrhage is best avoided?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Ergometrine

Ergometrine causes intense vasoconstriction and can precipitate severe hypertension, stroke and coronary spasm, so it is avoided in pre-eclampsia, hypertension and ischaemic heart disease. Oxytocin infusion, misoprostol and tranexamic acid do not carry this contraindication.

Option by option

  • A. Tranexamic acid

    Tranexamic acid reduces bleeding in postpartum haemorrhage and does not raise blood pressure.

  • B. Misoprostol

    Misoprostol does not cause significant vasoconstriction and can be used in hypertensive women.

  • C. Ergometrine (correct)

    Correct. Its vasoconstrictor effect can drive blood pressure dangerously high in a hypertensive woman.

  • D. Oxytocin infusion

    Oxytocin by slow infusion is the first-line uterotonic and is acceptable in pre-eclampsia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Ergometrine. Ergometrine causes intense vasoconstriction and can precipitate severe hypertension, stroke and coronary spasm, so it is avoided in pre-eclampsia, hypertension and ischaemic heart disease.

Why is "Tranexamic acid" not the answer?

Tranexamic acid reduces bleeding in postpartum haemorrhage and does not raise blood pressure.

Why is "Misoprostol" not the answer?

Misoprostol does not cause significant vasoconstriction and can be used in hypertensive women.

Why is "Oxytocin infusion" not the answer?

Oxytocin by slow infusion is the first-line uterotonic and is acceptable in pre-eclampsia.

What concept does this question test?

It tests Complications and emergencies: ergometrine in hypertensive disease in Anaesthesia. Oxytocin infusion, misoprostol and tranexamic acid do not carry this contraindication.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications and emergencies: ergometrine in hypertensive disease?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.