Methylergonovine Methergine Postpartum Hemorrhage

By the end of this lesson, you should be able to: 1. Explain how uterine atony causes primary postpartum haemorrhage and apply the four Ts framework when bleeding persists. 2. Identify ergonovine maleate as the Canadian ergot uterotonic and distinguish it from the US product methylergonovine. 3. Verify the timing, route, concentration and blood-pressure precautions required before an ergot uterotonic is administered. 4. Compare oxytocin, ergonovine, carboprost, misoprostol and tranexamic acid by indication, contraindication and treatment priority. 5. Recognize expected uterine cramping versus hypertension, vasospasm, myocardial ischaemia, seizure and other signs of ergot toxicity. 6. Select immediate nursing actions and escalation measures when bleeding continues despite uterine massage and uterotonics.