Essential second-line drugs, such as tranexamic acid and prostaglandin F2-alpha, and especially ergometrine
, were not available in several institutions, remarkably in three of the regional hospitals where difficult caesarean sections might be done.
Three categories of interventions can be identified (a) interventions on uterine arteries such as laparoscopic uterine artery ligation, uterine artery embolization, pericervical mechanical tourniquet for uterine arteries and hormonal tourniquets such as vasopressin; (b) uterotonics such as ergometrine
, oxytocin, misoprostol and sulprostone and (c) myoma dissection techniques which include the use of laser, electrosurgery and chemical dissectors such as sodium-2-mercaptoethanesulfonate (Mesna) (5-10).
Injection Oxytocin 20 IU and Inj Nexbolic (Methyl ergometrine
maleate) 3 ml was administered by l/M route on 1S1 day only.
The drug of first choice in third stage of labour in modern practice is syntocinon due to its excellent efficacy as well as few side effects as compared to ergometrine
Drug Interactions: Co-administration of cisapride, pimozide, quinidine, dofetilide, levacetylmethadol (levomethadyl), felodipine, oral midazolam, nisoldipine, triazolam, lovastatin, simvastatin, ergot alkaloids such as dihydroergotamine, ergometrine
(ergonovine), ergotamine and methylergometrine (methylergonovine) or methadone with ONMEL[TM] is contraindicated.
Similarly, the proforma for reporting gaps for the IPHS (28) includes Oxytocin and Ergometrine
(other important emergency obstetric drugs) but not MgS[O.
Non-hospital facilities typically did not have oxytocin but most had ergometrine
for post-partum haemorrhage; misoprostol was not available.
Atonic uterus - stepwise use of oxytocics (oxytocin infusion, ergometrine
, prostaglandins): B-Lynch compression suture (Fig.
Haemodynamic effects of oxytocin (syntocinon) and methyl ergometrine
(methergin) on the systemic and pulmonary circulations of pregnant anaesthetized women.
In previous cases associated with caesarean delivery (10,11), intravenous ergometrine
or treatment of bradycardia and hypotension after spinal anaesthesia with ephedrine and atropine therapy, were considered possible precipitating factors.
4% of women given an additional injection of ergometrine
, given to stop bleeding after the birth.
Aspirin ingredients are diverted into heroin production (32,000 tonnes of acetic anhydride were seized in 2007); birthing blood clotters such as ergometrine
double as LSD; even the anaesthetic diethyl ether gets diverted into cocaine production.
A prospective cohort study of oxytocin plus ergometrine
compared with oxytocin alone for prevention of postpartum haemorrhage.
The Czech Republic is a producer of ergometrine
, which is then used for the production of LSD.
Alkaloids, elimoklavine, festuklavine produce by Trichoderma and agroklavine, ergometrine
produce by Penicillium have antifungal activity against, Botrytis cinerea, Fusarium solani and Alternaria tenius as well as antibacterial action which depressed the growth of several pathogenic bacteria, cause the death of living cell.