Drugs in pregnancy: uterotonic choice in hypertension: practice question

A Pharmacology 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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Pharmacology · Drugs in pregnancy: uterotonic choice in hypertension

Sample item

A woman with severe pre-eclampsia and blood pressure of 170/110 mmHg has postpartum haemorrhage from uterine atony. Which uterotonic should be avoided?

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

The answer and the reasoning

B. Methylergometrine

Methylergometrine is an ergot alkaloid that causes sustained uterine contraction but also marked vasoconstriction, which can precipitate severe hypertension and stroke. It is contraindicated in hypertension and pre-eclampsia, and oxytocin remains the first-line drug.

Option by option

  • A. Carboprost

    Carboprost is used for refractory atony, and asthma rather than hypertension is its main contraindication.

  • B. Methylergometrine (correct)

    Correct. Methylergometrine causes vasoconstriction and severe hypertension.

  • C. Misoprostol

    Misoprostol can be used and does not raise blood pressure significantly.

  • D. Oxytocin

    Oxytocin is the first-line uterotonic, though it should not be given as a rapid bolus.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Methylergometrine. Methylergometrine is an ergot alkaloid that causes sustained uterine contraction but also marked vasoconstriction, which can precipitate severe hypertension and stroke.

Why is "Carboprost" not the answer?

Carboprost is used for refractory atony, and asthma rather than hypertension is its main contraindication.

Why is "Misoprostol" not the answer?

Misoprostol can be used and does not raise blood pressure significantly.

Why is "Oxytocin" not the answer?

Oxytocin is the first-line uterotonic, though it should not be given as a rapid bolus.

What concept does this question test?

It tests Drugs in pregnancy: uterotonic choice in hypertension in Pharmacology. It is contraindicated in hypertension and pre-eclampsia, and oxytocin remains the first-line drug.

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 Drugs in pregnancy: uterotonic choice in hypertension?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.