Ergometrine administration for postpartum bleeding during caesarean section was associated with the development of Takotsubo or reverse Takotsubo cardiomyopathy in 3 previously healthy women.
Case Report (n=3)
Does ergometrine administration for postpartum bleeding cause Takotsubo cardiomyopathy in women with no prior cardiovascular history?
Ergometrine administration for postpartum bleeding can trigger Takotsubo cardiomyopathy even in women with no prior cardiovascular history, though LV function typically recovers rapidly.
We report three patients who developed Takotsubo cardiomyopathy (TTCM) or reverse TTCM following administration of ergometrine for postpartum bleeding. All three women were antenatally well with no personal or family history of any cardiovascular conditions. Shortly after birth, all three patients demonstrated cardiovascular compromise. Transthoracic echocardiogram (TTE) demonstrated markedly impaired left ventricular (LV) systolic function with either Takotsubo or reverse TTCM. All patients spent a period in the intensive care unit for inotropic support and commencement of heart failure therapy. Serial TTE demonstrated marked improvement with a normal LV ejection fraction within 13 days for all cases. By 6 months, all three women were off all heart failure medications. TTCM differs from peripartum cardiomyopathy, with LV ejection fraction typically recovering within 1 month of delivery. Judicious use of ergometrine in the management of an atonic uterus, even women with no cardiovascular history, is necessary.
Makarious et al. (Mon,) conducted a case report in Takotsubo cardiomyopathy (TTCM) or reverse TTCM (n=3). Ergometrine was evaluated on Development of Takotsubo cardiomyopathy (TTCM) or reverse TTCM and subsequent recovery. Ergometrine administration for postpartum bleeding during caesarean section was associated with the development of Takotsubo or reverse Takotsubo cardiomyopathy in 3 previously healthy women.