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The patient is delivered by cesarean section under general anesthesia.The baby and placenta are easily delivered, but the uterus is noted to be boggy and atonic despite intravenous infusion of Pitocin. All of the following are appropriate agents to use next except

A
Methylergonovine (Methergine) administered intramuscularly
B
Prostaglandin F2α (Hemabate) suppositories
C
Misoprostil (Cytotec) suppositories
D
Terbutaline administered intravenously
High-Yield Explanation
Methylergonovine, prostaglandin F2α, prostaglandin E1 (Misoprostil), and prostaglandin E2 (Hemabate)are all uretotonic agents than can be used in situations where there is a postpartum hemorrhage due to uterine atony. Terbutalinewould be contraindicated in this situation because it is a tocolytic that is used to promote uterine relaxation.

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