Can we use external bimanual clamping for ectopic rupture/mischarges with excessive bleeding and or signs of hemodynamic instability 

Regarding external uterine massage: This procedure will have no effect on bleeding related to miscarriages or ruptured ectopic pregnancy.  External uterine massage helps slow postpartum bleeding by increasing uterine atony after the placenta has been delivered.  In the scenarios you describe, the bleeding is not a result of uterine atony and there is no evidence that supports external uterine massage in these cases.

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