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MediumO&GPostpartum haemorrhageca-mccqe1ca-ccfpca-rcpsc-em

A 28-year-old woman has a spontaneous vaginal delivery complicated by a postpartum haemorrhage of approximately 1200 mL due to uterine atony. Despite uterine massage, she continues to bleed briskly. According to SOGC postpartum haemorrhage guidelines, what is the most appropriate next pharmacologic step?

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