If massaging the uterus for uterine atony is ineffective, the next step is generally to administer?

In cases of uterine atony, where the uterus fails to contract adequately after delivery, effective management is crucial to prevent excessive bleeding. Administration of oxytocin is considered the standard next step following ineffective uterine massage. Oxytocin acts as a uterotonic agent that stimulates uterine contractions, helping to promote hemostasis and reduce the risk of postpartum hemorrhage.

This medication is usually given intravenously or intramuscularly, and its effects can be rapid, making it an essential tool in managing atony. By augmenting uterine tone and contraction strength, oxytocin can effectively minimize bleeding and help restore normal uterine function.

Other options such as hysterectomy or uterine artery embolization are more invasive and typically considered only after other methods have failed or in specific complications. Additionally, magnesium sulfate does not facilitate uterine contraction; rather, it's used as a tocolytic or for seizure prophylaxis in conditions like preeclampsia. Therefore, the administration of oxytocin is the most appropriate and evidence-based immediate intervention in this scenario.