Effects of methylergonovine: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major Research Findings

Methylergonovine is a medication commonly used to prevent postpartum hemorrhage. Studies have revealed a range of effects associated with its use. One study showed that methylergonovine is effective in preventing postpartum hemorrhage when used in combination with oxytocin. 18 . However, research indicates that methylergonovine can have potential side effects such as cardiovascular issues, pulmonary edema, and impacts on newborns. 4 , 7 , 16 , 20 , 19 , 2 .

Benefits and Risks

Benefit Summary

Methylergonovine is a medication commonly used to prevent postpartum hemorrhage. It can be effective in preventing postpartum hemorrhage, especially when used in conjunction with other treatments like oxytocin. 18 .

Risk Summary

There are potential risks associated with methylergonovine use. These risks include cardiovascular issues, pulmonary edema, and impacts on newborns. 4 , 7 , 16 , 20 , 19 , 2 . These side effects should be considered carefully when using this medication.

Comparison between Studies

Commonalities

These studies suggest that methylergonovine can be effective in preventing postpartum hemorrhage. They also highlight the potential risks associated with its use, including cardiovascular issues, pulmonary edema, and impacts on newborns.

Differences

The studies provide varying results regarding the effectiveness and risks of methylergonovine. For example, 18 suggests its effectiveness in preventing postpartum hemorrhage, while 4 highlights its potential cardiovascular side effects. These discrepancies might be attributed to differences in study populations, methodologies, or other factors.

Consistency and Contradictions in Findings

The research on methylergonovine presents a mixed picture. It suggests effectiveness in preventing postpartum hemorrhage but also raises concerns about potential side effects. More research is needed to better understand these contrasting findings and to address these uncertainties.

Practical Application Considerations

Methylergonovine is a commonly used drug for preventing postpartum hemorrhage, but it's important to be aware of its potential side effects. Healthcare providers need to carefully weigh the benefits and risks when deciding to use this medication. They should also ensure that patients are informed about these potential complications.

Limitations of Current Research

The research on methylergonovine has limitations. The studies are often limited in size or have different methodologies, making it difficult to generalize the findings. Additionally, long-term effects of methylergonovine use are not fully understood. More research is needed to overcome these limitations and provide a clearer picture of the medication’s impact.

Future Research Directions

Further research on methylergonovine is necessary. This includes studies to assess its long-term effects, evaluate its safety in different populations, and explore interactions with other medications. These studies are crucial for gaining a more comprehensive understanding of methylergonovine’s benefits and risks.

Conclusion

Methylergonovine is a medication that can be effective in preventing postpartum hemorrhage, but it also has potential risks. The use of this drug should be carefully considered, and patients should be informed about the potential side effects. More research is needed to fully understand the benefits and risks of methylergonovine.

Literature analysis of 22 papers
Positive Content
10
Neutral Content
2
Negative Content
10
Article Type
3
0
0
3
20
2.

Post-partum myocardial ischemia due to intramuscular methylergonovine-induced coronary vasospasm: case report.

Author: JangSae K, BerlacherKathryn, HauspurgAlisse

Nitroglycerin for vasospasm
Coronary vasospasm
Myocardial ischemia
Postpartum hemorrhage

This case presentation describes a patient who experienced coronary vasospasm and myocardial ischemia after receiving intramuscular methylergonovine for postpartum hemorrhage management. The case highlights the rare but potential lethal complication of methylergonovine use and underscores the importance of early recognition and management of coronary vasospasm in postpartum patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Eclampsia with RCVS: Postpartum seizure provoked by methergine.

Author: KirschenGregory W, HoytKaterina, JohnsonEmily, PatelSilka

Seizure risk

Reversible cerebral vasoconstrictive syndrome (RCVS) should be considered as a differential diagnosis for seizures during the peripartum period, especially when vasoconstrictive agents are used.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
LetterA written message for communication and exchange of information between individuals.

Language : English

5.

A randomized controlled trial of methylergonovine prophylaxis after dilation and evacuation abortion.

Author: KernsJennifer L, PearlsonGeffan, MengeshaBiftu, HarterKristin, JacksonRebecca A, DreyEleanor A

Increased bleeding
Uterine bleeding

Prophylactic post-procedure methylergonovine does not improve excessive bleeding after dilation and evacuation (D&E) at 20-24 weeks. In fact, methylergonovine may increase uterine bleeding.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

5-HT<sub>1D</sub> receptors inhibit the monosynaptic stretch reflex by modulating C-fiber activity.

Author: Lucas-OsmaAna M, LiYaqing, MurrayKatie, LinShihao, BlackSophie, StephensMarilee J, AhnAndrew H, HeckmanC J, FenrichKeith K, FouadKarim, BennettDavid J

Clonus control

This study investigated the role of serotonin in regulating the monosynaptic stretch reflex (MSR) in rats with and without spinal cord injury (SCI). The study found that serotonin, through activation of 5-HT<sub>1D</sub> receptors, potently inhibited the MSR in both groups, but with a much higher dose needed in uninjured rats. The study also demonstrated that this effect was mediated indirectly by modulating C-fiber activity, not by directly acting on the MSR itself. The findings suggest that targeting serotonin and C-fibers could offer new strategies for managing clonus and tremor after SCI.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

New onset acute pulmonary edema after methylergonovine given during cesarean delivery of a patient with undiagnosed Raynaud's disease.

Author: KimI, LindemanK, MasearC

Pulmonary edema
Vasoactive properties

A case of a patient with undiagnosed Raynaud's disease who developed acute pulmonary edema after receiving methylergonovine for postpartum hemorrhage is presented. This case highlights the potential risks of using vasoactive medications in patients with Raynaud's disease, even in settings where pulmonary complications are rare.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Efficacy of methylergometrine during the early puerperium: a randomized double-blind placebo-controlled clinical trial.

Author: SpariceStefania, GiampaolinoPierluigi, SansoneAnna, SacconeGabriele, BerghellaVincenzo, Di CarloCostantino

Hemoglobin levels

This double-blind placebo-controlled clinical trial investigated the effect of oral methylergometrine on hemoglobin levels in puerperal women. The results showed no significant difference in hemoglobin levels between the methylergometrine and placebo groups, suggesting that oral methylergometrine does not improve hemoglobin levels in this population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Vasospastic angina: A literature review of current evidence.

Author: PicardFabien, SayahNeila, SpagnoliVincent, AdjedjJulien, VarenneOlivier

VSA management

Vasospastic angina (VSA) is a form of angina that occurs at rest. It is often underdiagnosed and requires careful diagnosis through provocative testing. Treatment for VSA involves lifestyle modifications, avoiding vasospastic agents, and medication such as calcium channel blockers, nitrates, and statins.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Laparoscopic Ligation of Uterine Vasculature for Fertility-Sparing Management of Postabortal Hemorrhage.

Author: MenderesGulden, Leon-MartinezDaisy, AzodiMasoud

Uterus preservation
Ureter injury
Uterine injury

Laparoscopic ligation of the uterine vessels is a safe and effective minimally invasive approach to preserve the uterus in hemodynamically stable patients with postabortal hemorrhage who desire future fertility. The procedure was performed without complications and resulted in excellent hemostasis.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Video-Audio MediaMedia that combines video and audio. Includes movies, TV shows, and online videos.

Language : English

11.

Use of medications to decrease bleeding during surgical abortion: a survey of abortion providers' practices in the United States.

Author: WhitehouseKatherine, FontanillaTiana, KimLeslie, TschannMary, SoonReni, SalcedoJennifer, KaneshiroBliss

Bleeding during abortion

Most abortion providers routinely use medications to prevent bleeding during surgical abortion. They typically use vasopressin, methylergonovine, or misoprostol. More research is needed to guide providers on the use of these medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Obstetric interventions and maternal morbidity among women who experience severe postpartum hemorrhage during cesarean delivery.

Author: SeligmanK, RamachandranB, HegdeP, RileyE T, El-SayedY Y, NelsonL M, ButwickA J

Postpartum hemorrhage

This study examined surgical interventions, blood component use, and maternal outcomes among women experiencing severe postpartum hemorrhage after prelabor cesarean delivery compared to intrapartum cesarean delivery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Uterotonic Medications: Oxytocin, Methylergonovine, Carboprost, Misoprostol.

Author: ValleraCristianna, ChoiLynn O, ChaCatherine M, HongRichard W

Uterine atony treatment
Severe side effects

This article reviews the current role of oxytocin, methylergonovine, carboprost, and misoprostol in the prevention and treatment of uterine atony, a common cause of postpartum hemorrhage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Outcome of breastfed infants following post-partum methylergonovine treatment.

Author: GiladOded, MerlobPaul, StahlBracha, AverbuchNoa, KlingerGil

Breastfeeding safety
Methylergonovine
Neonatal complications

This observational study of 29 mothers and infants exposed to methylergonovine through breastfeeding found no adverse long-term outcomes compared to a control group of 58 mothers and infants. The findings support continuing breastfeeding for mothers requiring methylergonovine treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

16.

Exposure to methylergonovine maleate as a cause of sirenomelia.

Author: CozzolinoMauro, RivielloChiara, FichtelGertrud, TommasoMariarosaria Di

Sirenomelia

This case report describes a case of sirenomelia potentially associated with the use of methylergonovine maleate during early pregnancy. The authors suggest that exposure to methylergonovine maleate at a critical stage of organogenesis could be a contributing factor to the development of sirenomelia.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Uterotonics and tocolytics for anesthesiologists.

Author: SumikuraHiroyuki, InadaEiichi

Oxytocin remains the first-line uterotonic for cesarean section. Methylergonovine is a superior second-line uterotonic to carboprost. The role of tocolytic agents in obstetric anesthesia has not been well studied.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

The Effect of the Combined Use of Methylergonovine and Oxytocin during Caesarean Section in the Prevention of Post-partum Haemorrhage.

Author: ŞentürkŞenol, KağıtçıMehmet, BalıkGülşah, ArslanHalit, Kır ŞahinFigen

Prevents uterine atony
Reduced postpartum hemorrhage

The combined use of methylergonovine and oxytocin infusion during the intra-operative period of Caesarean section reduced the level of post-partum haemorrhage considerably without any adverse side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

19.

Cesarean Delivery in a Parturient with Left Ventricular Noncompaction Complicated by Acute Pulmonary Hypertension After Methylergonovine Administration for Postpartum Hemorrhage.

Author: SpitzerYelena, WeinerMenachem M, BeilinYaakov

LVNC complications

A parturient with left ventricular noncompaction developed decompensated heart failure and experienced an acute pulmonary hypertensive crisis during cesarean delivery.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

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

Author: DavanzoFranca, SettimiLaura, GiordanoFelice, CasiniMaria Luisa, FerrazinFernanda

Postpartum hemorrhage prevention
Newborn harm

This paper described cases of accidental methylergometrine maleate exposure in newborns in Italy, highlighting the need for careful prevention.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Patterns of second-line uterotonic use in a large sample of hospitalizations for childbirth in the United States: 2007-2011.

Author: BatemanBrian T, TsenLawrence C, LiuJun, ButwickAlexander J, HuybrechtsKrista F

This study examined hospital-level trends in the use of second-line uterotonic medications for postpartum hemorrhage caused by uterine atony in the United States. The study aims to provide insights into current practices and identify potential areas for improvement in managing postpartum hemorrhage.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

22.

Risk factors for obstetric morbidity in patients with uterine atony undergoing caesarean delivery.

Author: ButwickA J, CarvalhoB, El-SayedY Y

Postpartum hemorrhage

Risk factors for haemorrhage-related morbidity among patients undergoing Caesarean delivery with uterine atony are being investigated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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