A patient with rheumatic hea disease has PPH. Which of the following drugs is contraindicated?

Methylergometrine (Methergine) can be used in treatment of PPH. Absolute contraindications: 1. Hea disease in pregnancy. Hereafter the delivery of the placenta, almost 1000 ml of blood from the uterus goes back into the maternal circulation and this is a considerable load on an already weak hea . If Methylergometrine is used, then this extra blood is shifted much more rapidly to the systemic circulation casing a hea failure and a resultant Pulmonary Edema. 2. Chronic hypeension/preeclampsia/eclampsia.. similar reason i.e. too much blood into already hyperdynamic hypeesnive circulation. 3. After the delivery of the first baby of the twins. (It can be given after second baby delivery of twin.) 4. Rh iso immunization Hence, if the patient has a hea disease and develops PPH, methergine is absolutely contraindicated as it can cause hea failure.