Carboprost Tromethamine (Hemabate) is a synthetic 15-methyl-prostagladin F2 alpha (PGF2α) analog used primarily for postpartum hemorrhage related to uterine atony refractory to oxytocin administration. In my current practice, parturients with significant cardiovascular comorbidities (e.g., severe pulmonary hypertension, critical valvulopathies, cardiomyopathy, etc.) will have a primary obstetric anesthesiologist and a consulting cardiac anesthesiologist (which is how I get involved) for the cases.
After delivering the baby and beginning a Pitocin infusion, if the patient’s uterus remains “boggy”, my obstetric anesthesiologist colleagues will consider intramuscular Hemabate in patients who do not have a history of reactive airway diseases like asthma.
Drop me a comment with your experiences regarding Hemabate!