Journal of Clinical Toxicology
Open Access

Abstract

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

Ali Almudeer, Haitham Alhazemi and Abdulaziz Safhi

Background: Methylergometrine is an ergot alkaloid of ergonovine used to treat post-partum hemorrhage secondary to uterine atony. Mistaking methylergometrine for vitamin K with accidental administration to the neonate is a rare iatrogenic illness occurring almost exclusively in the delivery room setting. Complications of ergot alkaloids in neonates include respiratory depression, cyanosis, seizures, and death.

Case Report: A term male infant was inadvertently given 0.04 mg of methylergometrine intramuscularly. The error was only noted when the baby developed central cyanosis, after administration, identifying it as methylergometrine rather than vitamin K. The local poison center was notified, and the infant was transferred to the neonatal intensive care unit level III for observation. Few minutes after cyanosis, the infant was noted to have oxygen desaturations and prolonged apnea required oxygen via nasal cannula and ventilation as a respiratory support to maintain his oxygen. ECG and ECHO were done and ECG was normal and ECHO showed Large ASD secondum. Feeding was started by 48 hours of life, and the infant was discharged home in good condition after a 96-hour stay without further complications.

Disscussion: Because of the potential for serious adverse events, Look- alike Sound- alike policy and precaution is required to be applied to prevent accidental administration of methylergometrine to the neonate as a result of possible confusion with vitamin K in the early post-partum period.