Labour and delivery: oxytocin bolus hazard: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Labour and delivery: oxytocin bolus hazard

Sample item

A midwife gives 10 units of oxytocin as a rapid intravenous bolus after delivery. Which adverse effect is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Hypotension with tachycardia

Rapid intravenous bolus oxytocin causes vasodilatation, leading to a sudden fall in blood pressure with reflex tachycardia and flushing. It can be hazardous in women with cardiac disease or hypovolaemia, so oxytocin is given as a slow infusion or an intramuscular injection.

Option by option

  • A. Hypotension with tachycardia (correct)

    Correct. The vasodilator effect of a bolus causes hypotension and reflex tachycardia.

  • B. Hypertensive crisis

    Hypertension is a hazard of ergometrine, not of oxytocin.

  • C. Hyperkalaemia

    Hyperkalaemia is not an effect of oxytocin; hyponatraemia can occur with prolonged infusions.

  • D. Bradycardia with hyperglycaemia

    Oxytocin does not cause hyperglycaemia or bradycardia in this setting.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Hypotension with tachycardia. Rapid intravenous bolus oxytocin causes vasodilatation, leading to a sudden fall in blood pressure with reflex tachycardia and flushing.

Why is "Hypertensive crisis" not the answer?

Hypertension is a hazard of ergometrine, not of oxytocin.

Why is "Hyperkalaemia" not the answer?

Hyperkalaemia is not an effect of oxytocin; hyponatraemia can occur with prolonged infusions.

Why is "Bradycardia with hyperglycaemia" not the answer?

Oxytocin does not cause hyperglycaemia or bradycardia in this setting.

What concept does this question test?

It tests Labour and delivery: oxytocin bolus hazard in OBG. It can be hazardous in women with cardiac disease or hypovolaemia, so oxytocin is given as a slow infusion or an intramuscular injection.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Labour and delivery: oxytocin bolus hazard?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.