10.2.3  Inappropriate use of uterotonic agents

Whenever you use a uterotonic drug (drugs that cause uterine contraction, e.g. misoprostol, oxytocin or ergometrine) for active management of the third stage of labour (recall Study Session 6), you must first check that there is no other fetus in the uterus. This is because if you mistakenly administer a uterotonic agent when there is still a fetus in the uterus, it will contract so powerfully that it can easily rupture, especially in the case of multiparous women. Also it is likely to asphyxiate the baby.