A 32-year-old female, gravida 3, para 3, is evaluated in the labor and delivery unit for severe vaginal bleeding. She has a history of mild persistent asthma, for which she uses an inhaled corticosteroid and as-needed albuterol. Twenty minutes ago, she delivered a () infant vaginally after a prolonged second stage of labor. The placenta was delivered intact. She now has a continuous, brisk flow of vaginal blood. Her temperature is (), blood pressure is , and heart rate is . The uterus is soft, boggy, and palpated above the umbilicus. Intravenous oxytocin is running, and bimanual uterine massage is being performed, but the bleeding persists. Estimated blood loss is approximately .
Which of the following pharmacologic agents are appropriate to administer to this patient to control the hemorrhage? (Select 3)
- MethylergonovineCevap
- MisoprostolCevap
- Tranexamic acidCevap
- DCarboprost tromethamine
- EMagnesium sulfate
- FDesmopressin