Methylergometrine role in clinical practice

• Author Details:   
• Mayank Dhore ^*
• Atul Munshi
• Milind Gaitonde
• Ninad Chaudhary
• Monil Gala
• Snehal Muchhala
• Bhavesh Kotak

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Postpartum haemorrhage (PPH) is a major cause of morbidity and mortality, with uterine atony accounting for 70-80% of all haemorrhages. According to the experts, the incidence of PPH ranges from 3% to 5%. The most common causes include uterine atony, laceration, accidental haemorrhage, and abnormal placentation. Factors that increase the risk of PPH include advanced age, assisted reproduction technology, and advanced age-associated co-morbidities. Even though guidelines recommend oxytocin as the first option, experts consider methylergometrine to be the ideal uterotonic in clinical practice in case of either normal vaginal or C-section delivery. The current consensus article aims to provide a collation of evidence-based literature and clinical insights from the experts on epidemiology, risk factors, and predictors of PPH. The article also provides a consensus on the role of methylergometrine (methylergonovine) in the management of PPH. Overall, methylergometrine alone or in combination with oxytocin is among the first-line drugs for the management of PPH with a favourable safety profile and cost-effectiveness.