From the Research
The standard dose of ergometrine during cesarean section is typically 0.2 mg given by intramuscular or slow intravenous injection after delivery of the baby, as supported by the most recent and highest quality study 1. This medication is used to prevent or treat postpartum hemorrhage by causing the uterus to contract firmly. When administered intravenously, it should be given slowly over at least one minute to avoid causing a sudden spike in blood pressure. Ergometrine is often combined with oxytocin as Syntometrine (containing 0.5 mg ergometrine and 5 IU oxytocin), which provides both immediate and sustained uterine contraction. Important precautions include avoiding ergometrine in patients with hypertension, pre-eclampsia, cardiovascular disease, or hepatic or renal impairment, as it can cause dangerous elevations in blood pressure. Side effects may include nausea, vomiting, headache, and dizziness. Ergometrine works by stimulating alpha-adrenergic and serotonin receptors in the myometrium, leading to sustained uterine contractions that help control bleeding after delivery.
Some key points to consider when using ergometrine during cesarean section include:
- The dose and administration route: 0.2 mg given by intramuscular or slow intravenous injection after delivery of the baby 1.
- The combination with oxytocin: Syntometrine (containing 0.5 mg ergometrine and 5 IU oxytocin) provides both immediate and sustained uterine contraction.
- Precautions: avoiding ergometrine in patients with hypertension, pre-eclampsia, cardiovascular disease, or hepatic or renal impairment.
- Side effects: nausea, vomiting, headache, and dizziness.
It's worth noting that the most recent study 1 supports the use of ergometrine in cesarean section, and it's considered safe and feasible. However, it's always important to consider the individual patient's condition and medical history before administering any medication. In terms of comparison with other uterotonic agents, carbetocin has been shown to be a reasonable effective alternative to syntometrine in prevention of postpartum hemorrhage after cesarean delivery 2. But the choice of uterotonic agent should be based on the individual patient's needs and medical history.
The mechanism of action of ergometrine involves stimulating alpha-adrenergic and serotonin receptors in the myometrium, leading to sustained uterine contractions that help control bleeding after delivery 3. This understanding of the mechanism of action can help guide the use of ergometrine in clinical practice.
Overall, the use of ergometrine during cesarean section is supported by the most recent and highest quality study 1, and it's considered safe and feasible when used appropriately.