@article{GPM11545,
author = {Tiantian Cao and Meng Chen and Yihong Chen},
title = {Eclampsia associated with carboprost and ergometrine for postpartum hemorrhage: a case report},
journal = {Gynecology and Pelvic Medicine},
volume = {0},
number = {0},
year = {2026},
keywords = {},
abstract = {Background: Postpartum hemorrhage (PPH) is a common obstetric emergency worldwide, with an overall global incidence of approximately 10–15% of all deliveries; notably, uterine atony is the primary cause, accounting for 70–80% of all PPH cases. Uterotonic agents are initial treatment options for uterine atony. Oxytocin is recommended as the first-line agent, other second-line agents such as carboprost and ergometrine would be used when without contraindications. Eclampsia is a severe obstetric complication characterized by new-onset seizures in pregnant women with preeclampsia, which is associated with high maternal and perinatal morbidity and mortality if not promptly managed. In patients without hypertensive disorders, severe hypertension and eclampsia associated with carboprost and ergometrine are rare.Case Description: We report three cases of postpartum eclampsia associated with carboprost and ergometrine. They were aged from 26 to 32 years, all born at term via vaginal delivery. Three patients, all without previous hypertensive disorders, developed eclampsia shortly after uterotonics administration. Two of the three patients developed eclampsia-the main manifestations include generalized convulsions, trismus, frothing at the mouth, loss of consciousness, upward gaze, tonic rigidity of all four limbs, cyanosis of the face and lips, foaming at the mouth with a small amount of white froth, and unresponsiveness to verbal stimuli—within 10 minutes attribute to carboprost, and the other one occurred within 44 minutes attribute to the combination of carboprost and ergometrine. All three eclampsia patients received standardized emergency management prioritizing airway protection, magnesium sulfate seizure control, and blood pressure reduction, with mannitol and diazepam administered for refractory seizures, followed by intensive care unit admission. With timely intervention, all patients achieved seizure cessation, hemodynamic stabilization, and excellent clinical outcomes without severe complications. All neonates had perfect Apgar scores.Conclusions: Postpartum eclampsia associated with carboprost and ergometrine can be rare but catastrophic. Both of the agents should be given with caution, even in normotension patients.},
issn = {2617-4499}, url = {https://gpm.amegroups.org/article/view/11545}
}