Ergometrine (methylergometrine) is being considered as part of active management of the third stage of labor. In which of the following patients should this drug be withheld?
- A A woman with severe preeclampsia with blood pressure 170/112 mmHg ✓
- B A woman with chronic well-controlled asthma
- C A woman with a previous postpartum hemorrhage due to atony
- D A woman with gestational diabetes on diet control
Correct answer: A. A woman with severe preeclampsia with blood pressure 170/112 mmHg
Explanation
Ergot alkaloids cause sustained smooth muscle contraction of vessels as well as the uterus, producing marked hypertension. They are contraindicated in hypertensive disorders of pregnancy, including preeclampsia and chronic hypertension, and are avoided in cardiac disease. Asthma is the classic contraindication to carboprost (PGF2 alpha), not ergometrine, which is the distractor to eliminate. Previous PPH and diet-controlled diabetes are actually indications or neutral factors for prophylactic ergometrine.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.