Which postpartum sign suggests bronchospasm risk with a uterotonic?

• A. Coughing or wheezing after carboprost (Hemabate) administration in a patient with asthma.
• B. Severe headaches after oxytocin infusion.
• C. Hypotension after methylergonovine.
• D. Nausea after misoprostol.

Answer: (A)

Bronchospasm is a known risk with prostaglandin-based uterotonics, particularly carboprost. In someone with asthma, the bronchial smooth muscle is more reactive, so coughing or wheezing after administration signals possible bronchospasm and impending respiratory compromise. This makes the sign you’d look for after giving this drug the most critical to recognize, because it directly points to a life-threatening reaction that requires stopping the medication and treating the airway.

Other choices reflect different, less dangerous or unrelated effects of uterotonics: headaches can occur but aren’t tied to bronchospasm; methylergonovine can raise blood pressure and cause vasoconstriction rather than bronchospasm; misoprostol often causes nausea. So the postdrug coughing or wheezing in a patient with asthma best indicates a bronchospasm risk with this uterotonic.