Key result
Intramuscular administration of 0.2 mg methylergonovine maleate in a healthy 30-year-old postpartum patient resulted in severe delayed sinus bradycardia, hypertension, and chest pain.
Why the study?
Does methylergonovine maleate cause severe sinus bradycardia and hypertension in young, normal postpartum patients?
Case Report (n=1)
Does methylergonovine maleate cause severe sinus bradycardia and hypertension in young, normal postpartum patients?
Methylergonovine maleate can cause serious delayed side-effects like severe sinus bradycardia and hypertension in young, healthy postpartum patients, and subsequent atropine administration may lead to severe hypertension and tachycardia.
Answers are grounded in this paper and cite their sources.
Alerts clinicians to possible delayed effects with postpartum methylergonovine; leaves open causality and generalizability.
The case is reported of a 30-year-old multigravida, with insignificant history and stable vital signs, admitted to the labour room for normal vaginal delivery of twins. She received combined spinal epidural analgesia (bupivacaine plus fentanyl) for 3 h. Following uneventful delivery she received 0.2 mg methylergonovine maleate, intramuscularly. Nausea and vomiting occurred 70 min after placenta delivery, heart rate decreased, arterial blood pressure increased and there was chest pain. After excluding cardiac ischaemia, 0.5 mg atropine sulphate was administered intravenously. Chest pain improved but heart rate and blood pressure increased more than expected. The patient had mild headache and nausea, and antiemetic 4 mg ondansetron was given intravenously. Continuous monitoring for 4 h showed spontaneous chest pain relief and blood pressure improvement. In conclusion, serious delayed side-effects arising from methylergonovine maleate can occur in young, normal patients and close monitoring is required. Intravenous atropine sulphate following methylergonovine maleate administration may lead to severe hypertension and tachycardia.
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Ibrahim et al. (2008) conducted a case report in Postpartum severe sinus bradycardia (n=1). Methylergonovine maleate was evaluated on Severe sinus bradycardia, hypertension, and chest pain. Intramuscular administration of 0.2 mg methylergonovine maleate in a healthy 30-year-old postpartum patient resulted in severe delayed sinus bradycardia, hypertension, and chest pain.
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