1. Opioid analgesics
2. Prostaglandin $F2\alpha$
3. Prostaglandin E1
4. Ergometrine
Select the correct answer using the code given below.
Drugs to Avoid in Labouring Women with Bronchial Asthma
Bronchial asthma is a state of hyperreactive airways prone to bronchospasm. During labour and delivery, several commonly used obstetric drugs have known bronchoconstrictor or histamine-releasing properties and must be used cautiously or avoided in asthmatic patients, while others are actually bronchodilators and are safe (or even preferred).
Analysis of Each Option
- 1. Opioid analgesics: Avoided. Opioids such as morphine and pethidine cause direct mast cell degranulation and histamine release, which can precipitate bronchospasm and worsen respiratory status in an asthmatic patient in labour.
- 2. Prostaglandin F2α: Avoided. PGF2α (used for uterine atony/PPH, e.g., carboprost) is a potent bronchoconstrictor and smooth-muscle stimulant. It is contraindicated in asthmatics because it can trigger severe, sometimes fatal, bronchospasm.
- 3. Prostaglandin E1: Safe — not to be avoided. Unlike PGF2α, prostaglandin E1 (misoprostol) and E2 analogues cause bronchial smooth muscle relaxation (bronchodilation) rather than constriction. They are therefore considered safe for cervical ripening/induction and uterotonic use even in women with asthma.
- 4. Ergometrine: Avoided. Ergometrine (used for active management of the third stage of labour) can provoke bronchospasm and is also associated with vasoconstriction; it is best avoided in asthmatic and hypertensive patients.
Conclusion
The drugs that should be avoided in labouring women with bronchial asthma are Opioid analgesics (1), Prostaglandin F2α (2), and Ergometrine (4), since each can precipitate bronchospasm. Prostaglandin E1 (3) is a bronchodilator and is safe to use, so it is correctly excluded.
Therefore, the correct answer is 1, 2 and 4.
Important Questions from Complicated Labour Management
- Given below are the Obstetric maneuvers and their indications. Which one of the following is correctly matched?
- Which of the following are the pre-requisites of outlet forceps delivery?
1. Bladder should be empty
2. Membranes should be intact
3. Cervix should be fully dilated
4. Fetal skull has reached level of pelvic floor
Select the correct answer using the code given below : - Indications and prerequisites for delivery with the ventouse include which of the following?
1. Delay in the second stage of labour
2. Non-reassuring fetal heart rate
3. Gestation age less than 34 weeks of pregnancy
4. Vertex presentation
Select the correct answer using the code given below. - Which of the following statements are correct regarding constriction ring?
1. Premature rupture of membranes is a high risk factor.
2. It is situated at the junction of upper and lower uterine segment.
3. Uterus never ruptures.
4. The ring is felt per abdomen.
Select the correct answer using the code given below. - Which of the following are included in the management of cord prolapse during delivery?
1. Bladder emptying
2. Knee-chest position of the patient
3. Preferably caesarean delivery
4. Lifting up the presenting part of the cord
Select the correct answer using the code given below.
