Oxytocin (Syntocinon)

• MOA: Stimulates uterine smooth muscle contraction by acting on oxytocin receptors.
• IV Dose:
  • PPH: 10–40 units in 1 L IV infusion, rate per protocol.
  • Induction of labour: 0.5–2 milliunits/min IV, titrated to contractions.
• PO Dose: N/A
• Indication: Induction/augmentation of labour, prevention & treatment of PPH.
• Contraindications: Risk of fetal distress if hyperstimulation, uterine rupture (rare), caution in malpresentation.

Methylergometrine (Methylergonovine)*

• MOA: Ergot alkaloid causing sustained uterine contraction.
• IM Dose: 200 micrograms, may repeat every 2–4 h.
• IV Dose: Avoid if possible; if used, give slowly.
• PO Dose: N/A
• Indication: PPH due to uterine atony.
• Contraindications: Hypertension, pre-eclampsia, CVD.
  *Not licensed in UK — follow local guidance.

Carboprost (Hemabate)

• MOA: Prostaglandin F2α analogue causing strong uterine contractions.
• IM Dose: 250 micrograms, repeat every 15–90 min (max 2 mg).
• PO Dose: N/A
• Indication: Refractory PPH not responding to first-line agents.
• Contraindications: Asthma, significant cardiac/renal/hepatic disease.

Misoprostol

• MOA: Prostaglandin E1 analogue causing uterine contractions and cervical ripening.
• Rectal Dose (PPH): 600–1000 micrograms PR if indicated.
• PO/SL/PR Dose: 100–800 micrograms for labour induction or PPH (check BNF).
• Indication: Labour induction, cervical ripening, PPH.
• Contraindications: Previous uterine surgery (rupture risk), hypersensitivity; caution in asthma.

Magnesium Sulfate

• MOA: Reduces neuromuscular excitability, cerebral vasodilation, stabilises membranes.
• IV Dose (Eclampsia): 4 g IV over ~20 min, then 1–2 g/h infusion.
• PO Dose: N/A
• Indication: Seizure prophylaxis and treatment in pre-eclampsia/eclampsia.
• Contraindications: Myasthenia gravis, heart block, severe renal impairment; monitor reflexes, RR, urine output.

Terbutaline

• MOA: Beta-2 agonist that relaxes uterine smooth muscle (tocolysis).
• SC Dose: 250 micrograms every 20–30 min, up to 3 doses.
• PO Dose: N/A
• Indication: Short-term tocolysis in preterm labour.
• Contraindications: Tachycardia, uncontrolled hypertension, cardiac disease, hyperthyroidism.

Nifedipine

• MOA: Calcium channel blocker, relaxes uterine smooth muscle (tocolysis).
• PO Dose: 10–20 mg initially, then 10–20 mg every 4–6 h (per protocol).
• IV Dose: N/A
• Indication: Tocolysis in preterm labour.
• Contraindications: Hypotension, cardiac disease; avoid with IV magnesium sulfate.

Labetalol

• MOA: Alpha- and beta-blocker lowering BP.
• IV Dose: 20 mg IV bolus, may repeat or escalate; infusion per protocol.
• PO Dose: N/A
• Indication: Severe hypertension in pre-eclampsia/eclampsia.
• Contraindications: Asthma, heart block, bradycardia, heart failure; monitor HR and BP.

Hydralazine

• MOA: Direct arteriolar vasodilator, reduces afterload.
• IV Dose: 5–10 mg every 20–40 min, titrated to BP.
• PO Dose: N/A
• Indication: Acute severe hypertension in pre-eclampsia/eclampsia.
• Contraindications: Hypersensitivity; caution with hypotension or tachycardia.

Anti-D (Rho(D) Immune Globulin)

• MOA: Prevents maternal sensitisation to fetal Rh+ red cells.
• IM Dose: Standard postpartum 500 IU IM within 72 h of delivery or sensitising event (dose may vary; some use 1500 IU).
• PO/IV Dose: N/A (verify with local protocol/Kleihauer test).
• Indication: Prevention of Rh sensitisation in Rh- mother after Rh+ fetal blood exposure.
• Contraindications: Rh+ mother, hypersensitivity.