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Postpartum Severe Sinus Bradycardia following Methylergonovine Administration

Authors :
E Mustafa
A Louon
SM Ibrahim
Source :
Journal of International Medical Research. 36:1129-1133
Publication Year :
2008
Publisher :
SAGE Publications, 2008.

Abstract

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.

Details

ISSN :
14732300 and 03000605
Volume :
36
Database :
OpenAIRE
Journal :
Journal of International Medical Research
Accession number :
edsair.doi.dedup.....7188a58979dfaa527d90b9c460a403bd
Full Text :
https://doi.org/10.1177/147323000803600534