This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: JIPMER 2018, Subject name: Gynaecology & Obstetrics
Drug of choice in postpaum hemorrhage resistant to oxytocin and Ergomterine: 
Select and explain. 
A. Carboprost, B. Dinoprostone, C. Dinoprost, D. Misoprostol
A: Carboprost
Answer: A: Carboprost 
Explanation: Treatment for PPH - IV oxytocin ( 10 - 20 units drip ) ( DOC ) .when oxytocin given in bolus it can cause profound hypotension. thus, oxytocin should be given as a dilute solution by continuous intravenous infusion IV methyl ergometrine 0.2 mg ( peak act at 90 sec ) - IM also can be given Tab misoprostol ( PGE1 ) - 1000 mg / rectum Injection carboprost ( PGF2 a) * IM only * IV - sudden HTW