Ergometrine with oxytocin

How it works

Oxytocin produces rapid rhythmic uterine contractions while ergometrine adds a sustained tonic contraction, combining fast onset with prolonged uterine action to limit bleeding.

Prescribing in practice

• The ergometrine component makes it contraindicated in pre-eclampsia, eclampsia, hypertension and severe cardiac disease, where oxytocin alone is preferred.
• Give only after delivery of the baby (and not during the first or second stage), as it is unsuitable for induction or augmentation.
• Nausea and vomiting are more common than with oxytocin alone owing to the ergometrine component.

Monitoring

Monitor blood pressure, uterine tone and ongoing blood loss following administration.

Counselling the patient

• Feeling sick or vomiting can occur shortly after the injection.
• It is given by the maternity team to help the womb contract and reduce bleeding after birth.
• Share any history of high blood pressure or heart problems beforehand.

Evidence & guidelines

Combined ergometrine-oxytocin is recognised in RCOG guidance as an option for active management of the third stage where there are no contraindications to ergometrine.