Dear Martine,
There are references to this phenomenon occurring, but rarely, in the literature in the 1960s and 1970s, usually following administration of Ergometrine. Syntometrine is less likely to cause severe hypertension, with resultant eclamptic seizures, as the syntocinon fraction has a hypotensive effect, but it does still cause more hypertensive episodes than when no oxytocic is given. In the Dublin trial of third stage management 1429 women were randomly allocated to receive either "active" management using 0.5mg Ergometrine IV or "physiological", with no routine oxytocic drug. One woman in the "active" group who had no previous hypertension either antenatally or in labour, had an eclamptic fit 4 hours after delivery and another woman in the "active" group of the pilot study also had an eclamptic fit post delivery. The paper is attached.
Regards,
Cecily
Prof. Cecily M. Begley,
Chair of Nursing and Midwifery,
School of Nursing and Midwifery,
Trinity College Dublin,
24, D'Olier St.
Dublin 2
Tel: 353 1 8962693
Fax: 353 1 896 3001
-----Original Message-----
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]] On Behalf Of MIDWIFERY-RESEARCH automatic digest system
Sent: 24 February 2013 00:02
To: [log in to unmask]
Subject: MIDWIFERY-RESEARCH Digest - 22 Feb 2013 to 23 Feb 2013 (#2013-40)
There is 1 message totaling 64 lines in this issue.
Topics of the day:
1. syntometrine induced eclamptic fits
----------------------------------------------------------------------
Date: Sat, 23 Feb 2013 15:25:37 -0000
From: Martine Storey <[log in to unmask]>
Subject: syntometrine induced eclamptic fits
Hi midwives,
We have recently had a case whereby a low risk woman had a grand mal fit after being given syntometrine. She was treated with diazemuls and phenytoin. All her PET associated blood films were normal, as was her blood pressure. Her final diagnosis was eclamptic fit induced by syntometrine administration. In her subsequent pregnancy she was not offered or given this drug, getting syntocinon instead with no side effects.
My query is how frequent is this phenomena and is there an increase in its occurence? What are the factors that predispose to this happening?
Martine Storey
Labour Coordinator/Supervisor of Midwives
------------------------------
End of MIDWIFERY-RESEARCH Digest - 22 Feb 2013 to 23 Feb 2013 (#2013-40)
************************************************************************
|