Prostaglandin E 2 may cause vasodilatation and exacerbation of hypotension, therefore 15-Methyl prostaglandin F 2a is preferred. This prostaglandin agent may also be given by intramyometrial injection at cesarean delivery or transabdominally after vaginal delivery. The administration of 15-Methyl prostaglandin F 2a may be given in a dosage of 0.25 mg intramuscularly every 15 to 90 minutes (no more than eight doses). If there are any missing pieces still inside your womb, you may have to have them removed this is. This agent is contraindicated in the presence of hypertensive disease states because of the severe hypertension that may develop secondary to vasoconstriction induced by the agent. check to make sure that all of the placenta has come out. Methylergonovine may be administered in a dosage of 0.2 mg intramuscularly every two to four hours. According to the report, prostaglandin derivatives are associated with success rates of 88 percent when used alone and 95 percent when used in combination with other oxytocic agents. Other uterotonic agents include methylergonovine and prostaglandin derivatives (15-methyl prostaglandin F 2a). Abnormal involution of the placental site (inadequate closure and sloughing of the spiral arteries at the. Etiology Subinvolution results from retained placental fragments and membranes, endometritis, or uterine fibroid tumor treatment depends on the cause. In one study of routine ultrasound immediately after vaginal delivery, the sensitivity for diagnosing retained placental fragments was only 44 with a positive predictive value (PPV) of 58. Risk factors include Caesarean section, premature rupture of membranes and long labour. Description Subinvolution is delayed return of the enlarged uterus to normal size and function. Intravenous oxytocin, 10 to 40 U intravenously by continuous infusion, should be administered. The main causes of secondary post-partum haemorrhage are: Uterine infection (known as endometritis). Uterine atony should be initially managed by bimanual uterine massage and compression.
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