Methylergometrine Poisoning In The Newborn: Report Of Two Cases

Abstract

Methylergometrine is probably the most commonly used drug in obstetric care at all levels of the health care system. Many communities in Africa lack skilled birth attendants and adequate health systems; medication errors are more likely to occur and go unreported in these settings. The morbidity and mortality that result from these errors can be reduced if health care workers are better informed. We report two cases of medication error with methylergometrine and suggest guidelines for health care workers at the primary and secondary levels of health care.

Inadvertent oral administration of methylergometrine maleate to children in the first months of life: from surveillance to prevention

“…With specific reference to methylergometrine maleate, the observations reported in the literature since early ′70s on life‐threatening therapeutic errors due to injection to newborn children of uterotonic ergot alkaloids instead of vitamin K or Naloxone provided clear indications about the necessity to avoid the administration of non‐urgent drugs to the neonate immediately after birth in the delivery room . Nevertheless new cases of such a type of incident continue to be reported …”

“…2 Nevertheless new cases of such a type of incident continue to be reported. [7][8][9][10] Toxic effects due to oral administration to children in the first week of life of uterotonic ergot alkaloid had been documented in only two previous reports: a case of poisoning observed in Italy in 1985; 11 a review of 34 cases of oral exposure handled by the Belgian Poison Control Centre between 1969 and 1999, including 9 children aged <1 month presenting with low severity effects and a 15-day-old female baby who developed severe clinical toxicity. 12 In 2009, a retrospective analysis of the Moroccan Pharmacovigilance Centre database highlighted that one of the most frequent medication errors occurring in that country was administration of methylergometrine maleate to the wrong patients, mainly due to confusing prescription.…”

“…Accidental administration of this medicine to newborns can cause severe effects and should be carefully prevented. Since the early ′70s, cases of severe acute poisoning due to inadvertent injection in the delivery room of ergometrine or methylergometrine maleate in place of vitamin K or Naloxone have been reported . The victims of such an event usually develop encephalopathy, seizure, and peripheral vascular disturbances.…”

“…Since the early ′70s, cases of severe acute poisoning due to inadvertent injection in the delivery room of ergometrine or methylergometrine maleate in place of vitamin K or Naloxone have been reported. [2][3][4][5][6][7][8][9][10] The victims of such an event usually develop encephalopathy, seizure, and peripheral vascular disturbances. Most of them require ventilatory support.…”

An unusual mimicker of a sepsis outbreak: ergot intoxication

“…It is usually kept in labor rooms for immediate parenteral use during the last stage of labor. Most instances of neonatal MEV poisoning have occurred when infants inadvertently receive the ergot derivatives instead of vitamin K or naloxane [8].…”