Accidental Poisoning of Newborn Infants with Ergonovine Maleate

Inadvertent Methylergometrine Administration to a Neonate with Underline Acyanotic Congenital Heart Disease

“…Currently, Methylergometrine maleate (Methergine) MEM is the ergot most commonly used for post-partum uterine atony. Typical effect in newborn as a side effect includes respiratory depression or distress, cyanosis, pallor, hypertension, vasoconstriction, hypoxia, and feeding intolerance decreased capillary refill, oliguria, and seizures [7][8][9][10]. Respiratory depression is the most common and immediately lifethreatening manifestation, presenting in up to 55% of cases within six hours of intramuscular (IM) administration [2,9].…”

Neonatal Ergot Poisoning: A Persistent Iatrogenic Illness

“…The etiology is probably a combination of direct central nervous system toxicity 24 and cerebral hypoperfusion. 3 Three neonatal fatalities have been documented in the world literature, 8,15,18 representing an overall mortality rate of 5.5% (three of 55 orally and parenterally poisoned newborns). Most of the deaths were reported several decades ago in infants who could not benefit from modern neonatal intensive care.…”

“…Death is usually caused by respiratory arrest. 8,15,18 Symptoms and signs often develop within 1 hour of exposure, but may be delayed for several hours. All newborns exposed to an ergot should be transferred to a NICU for observation and intervention.…”

“…Ergot toxicity in the newborn is almost exclusively iatrogenic-the result of administering an ergot dose intended for the mother to her newborn. The mix-up most commonly involves a uterotonic ergot and vitamin K. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] This substitution has become less common in hospitals that have adopted the recommendation to administer vitamin K in the newborn nursery rather than in the delivery room. However, both maternal and neonatal resuscitation drugs remain essential in the delivery room, and this case involves the injection of methylergonovine, rather than naloxone, for respiratory depression in a newborn.…”

Mycotoxins

“…183 The skin lesions appeared on the second day and subsided about the fi fth day. Accidental parenteral administration of 0.2 mg ergonovine to newborn infants was associated with cutaneous erythema and hemorrhagic blebs on the extremities, groin, and genitalia.…”