Korean J Obstet Gynecol.  2012 Aug;55(8):578-581. 10.5468/KJOG.2012.55.8.578.

Maternal cardiac arrest after intravenous methylergonovine administration during Cesarean section: A case report

Affiliations
  • 1Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea. tbsong@chonnam.ac.kr

Abstract

Methylergonovine is commonly used for the prevention and treatment of postpartum hemorrhage, which promotes contractions of uterine and vascular smooth muscles. However, this drug precipitates serious cardiac complications such as ischemic heart disease, acute myocardial infarction and cardiac arrest in some patients as a consequence of coronary artery spasm. Cardiac complication of methylergonovine is often overlooked by an obstetrician because the frequency of this is very low during postpartum. We report a case of maternal cardiac arrest induced by intravenous methylergonovine which was recovered by prompt cardiac resuscitation and adequate medical treatment during Cesarean section of triplet pregnancy.

Keyword

Methylergonovine; Cardiac arrest; Cesarean section

MeSH Terms

Cesarean Section
Contracts
Coronary Vessels
Female
Heart Arrest
Humans
Methylergonovine
Muscle, Smooth, Vascular
Myocardial Infarction
Myocardial Ischemia
Postpartum Hemorrhage
Postpartum Period
Pregnancy
Pregnancy, Triplet
Resuscitation
Spasm
Methylergonovine

Reference

1. Arky R. Physicians' desk reference. 1996. 50th ed. Montvale (NJ): Medical Economics Company.
2. Liao JK, Cockrill BA, Yurchak PM. Acute myocardial infarction after ergonovine administration for uterine bleeding. Am J Cardiol. 1991. 68:823–824.
3. Tsui BC, Stewart B, Fitzmaurice A, Williams R. Cardiac arrest and myocardial infarction induced by postpartum intravenous ergonovine administration. Anesthesiology. 2001. 94:363–364.
4. Taylor GJ, Cohen B. Ergonovine-induced coronary artery spasm and myocardial infarction after normal delivery. Obstet Gynecol. 1985. 66:821–822.
5. Yaegashi N, Miura M, Okamura K. Acute myocardial infarction associated with postpartum ergot alkaloid administration. Int J Gynaecol Obstet. 1999. 64:67–68.
6. Pristipino C, Beltrame JF, Finocchiaro ML, Hattori R, Fujita M, Mongiardo R, et al. Major racial differences in coronary constrictor response between japanese and caucasians with recent myocardial infarction. Circulation. 2000. 101:1102–1108.
7. Chant GN. Coronary anatomy in postpartum acute myocardial infarction. Am J Cardiol. 1980. 45:912.
8. Hayashi Y, Ibe T, Kawato H, Futamura N, Koyabu S, Ikeda U, et al. Postpartum acute myocardial infarction induced by ergonovine administration. Intern Med. 2003. 42:983–986.
9. Lange RA, Hillis LD. Pepine CJ, Hill JA, Lambert CR, editors. Assessment of cardiovascular function. Diagnostic and therapeutic cardiac catheterization. 1994. 2nd ed. Baltimore (MD): Williams & Wilkins;394–429.
10. Fester A. Provocative testing for coronary arterial spasm with ergonovine maleate. Am J Cardiol. 1980. 46:338–340.
11. de Groot AN, van Dongen PW, VreeTB , Hekster YA, van Roosmalen J. Ergot alkaloids. Current status and review of clinical pharmacology and therapeutic use compared with other oxytocics in obstetrics and gynaecology. Drugs. 1998. 56:523–535.
12. Mayer DC, Spielman FJ. New practice guidelines for obstetric anesthesia. Obstet Gynecol Surv. 2000. 55:593–594.
13. Ibrahim SM, Mustafa E, Louon A. Postpartum severe sinus bradycardia following methylergonovine administration. J Int Med Res. 2008. 36:1129–1133.
14. Ko WJ, Ho HN, Chu SH. Postpartum myocardial infarction rescued with an intraaortic balloon pump and extracorporeal membrane oxygenator. Int J Cardiol. 1998. 63:81–84.
15. Sutaria N, O'Toole L, Northridge D. Postpartum acute MI following routine ergometrine administration treated successfully by primary PTCA. Heart. 2000. 83:97–98.
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