Monday, May 28, 2012


You are delivering twins to a G1P0 34 year old woman at 38 weeks with a prolonged labor. Because of uterine atony, you write an order in the chart: "Methylergonovine 0.2mg x1 now." You are called ten minutes later because the patient's blood pressure is suddenly 180/100 and she has a facial droop and a weak arm and leg.

Challenge: What happened?

Image is in the public domain.


Sean said...

Methylergonovine initiates transient hypertension and the mother suffered from cerebral hypoxic ischemic injury?

Craig Chen said...

yes - exactly right

If methergine is given intravenously rather than intramuscularly, there is a risk of hypertension and cerebrovascular accident.

Sources: UpToDate; Wikipedia.